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Purpose <p>A novel dynamic optical metric derived from double-pass imaging called the Lacrima Stability Index (LaSI) was evaluated for the objective assessment of tear film stability.</p> Methods <p>Retinal point spread functions were recorded with an open-view double-pass system at 15.4 Hz with simultaneous pupil tracking. LaSI was defined as the central PSF energy normalised by the total light exiting the eye, and the time-to-90% decay (T90) was introduced as the time for LaSI to decline by 10%.</p> Results <p>In 39 eyes, LaSI traces remained stable in eyes with normal tear film stability but showed progressive decline in eyes with an unstable tear film. Using a 10-s cutoff to distinguish normal from reduced tear film stability subjects, T90 correctly classified 84.6% of eyes and showed a strong correlation with non-invasive break-up time (<i>r</i> = 0.76, <i>p</i> &lt; 0.001). Agreement with the Ocular Surface Disease Index-6 scores was comparable for T90 and the non-invasive tear break-up time, although differences reflected the known dissociation between signs and symptoms.</p> Conclusions <p>These findings suggest that LaSI provides a sensitive, time-resolved metric of tear film dynamics, with T90 serving as a clinically interpretable marker of tear film stability.</p>

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Dynamic Tear Film Stability Assessed via an Open-View Double-Pass Imaging System

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月3日

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  • Spyridon Tsoukalas,
  • Alexandros Pennos,
  • Clara Bonel Pla,
  • Anastasios Charonis,
  • Pablo Artal,
  • Harilaos Ginis,
  • Dimitrios Christaras

摘要

Purpose

A novel dynamic optical metric derived from double-pass imaging called the Lacrima Stability Index (LaSI) was evaluated for the objective assessment of tear film stability.

Methods

Retinal point spread functions were recorded with an open-view double-pass system at 15.4 Hz with simultaneous pupil tracking. LaSI was defined as the central PSF energy normalised by the total light exiting the eye, and the time-to-90% decay (T90) was introduced as the time for LaSI to decline by 10%.

Results

In 39 eyes, LaSI traces remained stable in eyes with normal tear film stability but showed progressive decline in eyes with an unstable tear film. Using a 10-s cutoff to distinguish normal from reduced tear film stability subjects, T90 correctly classified 84.6% of eyes and showed a strong correlation with non-invasive break-up time (r = 0.76, p < 0.001). Agreement with the Ocular Surface Disease Index-6 scores was comparable for T90 and the non-invasive tear break-up time, although differences reflected the known dissociation between signs and symptoms.

Conclusions

These findings suggest that LaSI provides a sensitive, time-resolved metric of tear film dynamics, with T90 serving as a clinically interpretable marker of tear film stability.