Tear film osmolarity: determination of a referent for dry eye diagnosis

Alan Tomlinson, Santosh Khanal, Kanna Ramaesh, Charles J.M. Diaper, Angus K. McFadyen

Research output: Contribution to journalArticlepeer-review

420 Citations (Scopus)


The purpose of this study was to determine new referents, or cutoff levels for tear film hyperosmolarity in the diagnosis of keratoconjunctivitis sicca (KCS) and to assess their effectiveness in independent patient groups. Tear hyperosmolarity, defined by a referent of 316 mOsmol/L, was superior in overall accuracy to any other single test for dry eye diagnosis (Lactoplate, Schirmer test, and Rose Bengal staining), even when the other test measures were applied to a diagnosis within the sample groups from which they were derived. For overall accuracy in the diagnosis of dry eye, the osmolarity test was found to be comparable with the results of combined (in parallel or series) tests.

Original languageEnglish
JournalInvestigative Ophthalmology & Visual Science
Publication statusPublished - 1 Oct 2006


  • dry eye
  • vision sciences
  • keratoconjunctivitis sicca
  • osmolarity


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