Diurnal Variation in Tear Osmolarity

Study Overview
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Brief Summary
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The purpose of this study is to measure the change in Tear Osmolarity during the course of the day to support clinical diagnosis of aqueous deficiency or meibomian gland disease and differentiate between the two forms of dry eye.

Detailed Description
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The premise of this study is that dry eye disease, specifically tear osmolarity, changes during the course of the day based on the etiology of the dry eye and that aqueous-deficiency dry eye will worsen during the course of the day while meibomian gland deficiency will stabilize or possibly even improve during the course of the day.

Official Title
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Investigator Sponsored, Pilot Study to Assess the Diurnal Variation in Tear Osmolarity as a Predictor of Dry Eye Disease Etiology

Conditions
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Dry Eye Disease

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthy males and females ≥ 18 years old Negative urine pregnancy results for females of childbearing potential Able to read and sign an informed consent form and show willingness to comply with the study protocol visits and procedures Has 20/40 BCVA or better in at least one eye Does not currently wear contact lenses For Aqueous-Deficiency Group: Has symptoms of Dry Eye Schirmer testing ≤ 10 mm Tear Break Up Time ≤ 8 seconds Conjunctival staining ≥ 1+ Meibomian gland inspissations ≤ 1+ No lid thickening, lid erythema, or thickened, turbid meibomian gland secretions For Meibomian Gland Disease Group: Has symptoms of Dry Eye Schirmer testing ≥ 10 mm Tear Break Up Time ≤ 8 seconds Conjunctival staining ≥ 1+ Meibomian gland inspissations ≥ 2+ For Normal Group: Has no symptoms of Dry Eye Schirmer testing > 10 mm Tear Break Up Time > 8 seconds No or trace Conjunctival staining No Meibomian gland inspissations Exclusion Criteria: Any topical medication within the last three months, except for artificial tears Unable to discontinue use of artificial tears during the course of the day for Visit 2 Any Systemic disease, which in the opinion of the Investigator, may affect ocular health or confound study results Any active ocular disease other than Dry Eye Disease, Meibomian Gland Disease or Sjogren's Syndrome, which in the opinion of the Investigator, may affect ocular health or confound study results Clinically significant lid or conjunctival abnormalities, neovascularization, corneal scars or corneal opacities Clinically significant limbal or bulbar injection, or corneal staining not due to DES Has worn hard or rigid gas permeable contact lenses within 1 year Has worn soft contact lenses within 1 week Has had eye surgery or an eye injury within 6 months Positive urine pregnancy results for females of childbearing potential Any changes in current medication within 30 days of Visit 2 or anticipated change during course of study, which in the opinion of the Investigator may confound study results

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Aqueous Dificiency Dry Eye<br>20 Participants | |
| Meibomian Gland Disease Dry Eye<br>20 Participants | |
| Normal Eye<br>20 Participants | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The measured difference in Tear Osmolarity during the course of the day to support clinical diagnosis and differentiate between aqueous-deficiency and meibomian gland disease. |  | 1 Day (AM and PM Diurnal) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ocular Improvement | Improvement in Ocular Surface Disease Index, Best Corrected Visual Acuity, Uncorrected Visual Acuity, Slit Lamp Exam, Schirmer test, Lissamine green conjunctival staining, Fluorescein corneal staining and Tear Break Up Time | 31 Days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dry Eye, Tear Osmolarity, Meibomain Gland Disease, Aqueous Dificiency, Tear film abnormality