Original Research

An investigation of the relationship between tear meniscus height and the subjective severity of ocular symptoms in keratoconus

Deanne L. Nicholas, Wayne D.H. Gillan
African Vision and Eye Health | Vol 74, No 1 | a306 | DOI: https://doi.org/10.4102/aveh.v74i1.306 | © 2015 Deanne L. Nicholas, Wayne D.H. Gillan | This work is licensed under CC Attribution 4.0
Submitted: 26 March 2015 | Published: 06 November 2015

About the author(s)

Deanne L. Nicholas, Department of Optometry, University of Johannesburg, South Africa
Wayne D.H. Gillan, Department of Optometry, University of Johannesburg, South Africa


Keratoconus is a debilitating disease in which the cornea does not develop its characteristic round shape but develops into a conical form affecting both functional vision as well as ocular comfort. Depending on the severity of the keratoconus as well as the presence of any associated conditions, keratoconic individuals may complain of various symptoms that include discomfort, irritation, dryness, reflex tearing and foreign body sensation. There are various subjective and objective measures that can be used to determine the severity of these symptoms. A subjective method that is widely used is the ocular surface disease index (OSDI) which has been shown to be fairly accurate when diagnosing dry eye disease; however, these symptoms do not correlate with objective measures of dry eye. Research has revealed the various structural and biochemical changes that take place within a keratoconic cornea; however, the tear dimensions of keratoconic subjects have not been extensively investigated. It is possible that the symptoms experienced by many keratoconic individuals might be linked to alterations within the quantity of the tears of these patients. The present study compared the symptoms experienced by keratoconic individuals with the symptoms of control patients. The differences in tear meniscus heights between keratoconic individuals and those of control individuals were also compared using the Oculus Keratograph 4 (OK4). The results of the study show the absence of a relationship between the subjective symptoms experienced and the height of the tear meniscus.


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