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    How tear proteomics can help optometry

    Laboratory testing has not traditionally been a feature of an eyecare practice. Optometrists may obtain blood work for a patient with a recurrent anterior uveitis or order imaging for a suspected orbital fracture, but routine ocular point-of-care (POC) tear testing isn’t part of our normal daily routine.

    I suggest it should be now, and I predict that it will be in the near future.

    Think about what occurs when you visit your doctor for a cold. Technicians will gather your vital signs; likely draw blood to check your white cell count; obtain a throat swab for a Streptococcal pharyngitis, a sinus swab for flu, and a chest X-ray. The results of these tests are at the physician’s disposal before he ever steps foot into the exam room to see you.

    Related: How point-of-care diagnostic lab tests help clinical decisions

    With POC tear testing, eyecare professionals now have the ability to gather laboratory data to aid diagnostic decision making.

    Advantages of tear testing

    In-office POC tear testing is feasible due to the multifaceted functions of tears and advances in proteomics, a branch of biotechnology concerned with applying the techniques of molecular biology, biochemistry and genetics to analyzing the structure, function, and interaction of proteins produced by a particular cell, tissue, or organism.1

    Despite the small sample volume, tear fluid offers advantages for biochemical analysis.

    Tear sample collection is a non-invasive process. Tears can be easily obtained from healthy subjects, while other ocular fluids (i.e., aqueous and vitreous) are not realistic for routine collection and carry risks with their capture, such as endophthalmitis.

    Perhaps the greatest advantage is that tears are close to the disease site (as in ocular surface disease) as compared to detecting cancer biomarkers in blood where the biomarker molecules are highly diluted.2

     

    Ernie Bowling, OD, MS, FAAO
    Dr. Ernie Bowling is Chief Optometric Editor of Optometry Times. He received his Doctor of Optometry and Master of Science in ...

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