The utility of measuring tear film break-up time for prescribing contact lenses.

Purpose: To evaluate the clinical value of non-invasive keratograph tear film breakup time (NIKBUT) in the assessment of pre-corneal and pre-lens tear film quality for prescribing contact lenses (CLs).

Methods: Forty-six subjects aged 25.5±4.3 (mean±standard deviation) years were recruited. Visual acuity (VA), anterior eye health checks and NIKBUT were evaluated. On the following day, subjects were fitted with a daily Silicon Hydrogel (SiHy) CL in one eye and a Hydrogel (Hy) CL in the other. After four hours one material for both eyes was chosen based on a qualitative analysis which included VA, CL fitting and comfort. Information about the first and the mean NIKBUT was then contrasted against the prescription decision.

Results: Thirty-four subjects were fitted with SiHy and twelve with Hy CL. No statistically significant differences were found for both NIKBUT parameters between left and right eye at baseline (p=0.38 and p=0.50, respectively) and post four hours of CL wear (p=0.61 and p=0.06). The chosen lens did not always correspond to longer NIKBUT. In 39.1% and 34.8% of cases (i.e., 18 and 16 out of 46), there was a match between prescription decision and the first and the mean NIKBUT results, respectively.

Conclusions: Although there is no evidence whether tear film surface quality measurement has a superior diagnostic values compared to other traditional clinical measures used in practice, NIKBUT measurements have provided additional information that could be of interest during CL fit.