Medical hypothesis, discovery & innovation in optometry

Abstract

Background: Dry eye disease (DED) is a multifactorial condition with a globally rising prevalence. Diagnosis relies on both symptoms and clinical tests, but these methods demonstrate variability. Strip meniscometry (SMTube) represents a rapid, non-invasive alternative method, but its diagnostic value remains uncertain. We evaluated the correlation of its findings with those of established DED evaluations.
Methods: In this cross-sectional study, we recruited 100 individuals with and without DED (n = 50 each) who visited a tertiary ophthalmology clinic. Diagnosis of DED was based on symptomatology and standard criteria, including a tear break-up time (TBUT) < 5 s or Schirmer test I result < 5 mm, along with an Ocular Surface Disease Index (OSDI) score > 12 and corneal fluorescein staining grade > 1. The exclusion criteria included ocular surgery, allergy, or contact lens use. All participants underwent comprehensive ophthalmic examination and standardized DED assessments (OSDI, tear meniscus height [TMH], SMTube, TBUT, corneal fluorescein staining, and Schirmer test I), conducted in a controlled setting by a single examiner during 9–11 AM to ensure consistency.
Results: The DED group was significantly older (P < 0.05). No significant sex difference was observed between groups (P > 0.05). The OSDI, TMH, SMTube, TBUT, corneal fluorescein staining, and Schirmer test I findings differed significantly (all P < 0.001), while SMTube application discomfort rates were similar between groups (P > 0.05). In the DED group, SMTube correlated moderately with TBUT (r = + 0.41, P < 0.05) and OSDI (r = + 0.43, P < 0.05), while the Schirmer test I correlated weakly with TBUT (r = + 0.34, P < 0.05) and moderately with TMH (r = + 0.52, P < 0.05). In the controls, no significant correlations were observed between tear metrics and SMTube or Schirmer test I findings (all P > 0.05), except for corneal fluorescein staining, which showed a weak negative correlation with SMTube (r = - 0.28, P < 0.05) and a moderate positive correlation with Schirmer test I findings (r = + 0.51, P < 0.05).
Conclusions: SMTube findings differed significantly between the DED and control groups and correlated moderately with those of established diagnostic assessments, particularly the TBUT and OSDI. Unlike Schirmer testing, SMTube results are closely associated with symptom severity, suggesting its utility in reflecting patient-reported discomfort. Given its simplicity, non-invasiveness, and correlation with key clinical indicators, SMTube may serve as a valuable adjunct in the multimodal assessment of DED. However, further studies are needed to establish its diagnostic accuracy and to confirm its clinical utility.