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    How tear proteomics can help optometry



    Human tears are a complex extracellular fluid of the ocular surface which contains molecular information useful in the diagnosis and treatment of ocular surface diseases and has the ability to address an emphasis on personalized medicine and disease biomarkers.16

    Tear collection is fast, safe, non-invasive, and yields data helpful in determining local pathology close to the disease site. The relatively simple sample preparation techniques make tears an ideal source for laboratory diagnosis and prognosis. See Figure 3.

    Related: A new player in point-of-care allergy testing

    The time will arrive when a tear test used in eye clinics will become as valuable as a blood test or a urine test to aid in the diagnosis and treatment of our patients’ diseases.

    Says Smith, “The clinical value of POC testing is simple: It is better to know than to think you know.”


    1. Definition of proteomics. Merriam-Webster Dictionary. Available at: www.merriam-webster.com/dictionary/proteomics. Accessed 4/21/2017.

    2. Zhou L, Bewerman RW. The power of tears: how tear proteomics research could revolutionize the clinic. Expert Rev Proteomics. 2017 Mar;14(3):189-191.

    3. Zhou L, Zhao SZ, Koh SK, Chen L, Vaz C, Tanavde V, Li XR, Beuerman RW. In-depth analysis of the human tear proteome. J Proteomics. 2012 Jul 16;75(13):3877-85.

    4. Chen L, Zhou L, Chan EC, Neo J, Beuerman RW. Characterization of the human tear metabolome by LC-MS/MS. J Proteome Res. 2011 Oct 7;10(10):4876-82.

    5. Lam SM, Tong L, Duan X, Acharya UR, Tan JH, Petznick A, Wenk MR, Shui G. Longitudinal changes in tear film lipidome brought about by eyelid warming treatment in a cohort of meibomian gland dysfunction. J Lipid Res. 2014 Sep;55(9):1959-69.

    6. D'Souza S, Petznick A, Tong L, Hall RC, Rosman M, Chan C, Koh SK, Beuerman RW, Zhou L, Mehta JS.Comparative analysis of two femtosecond LAASIK platforms using iTRAQ quantitative proteomics. Invest Ophthalmol Vis Sci. 2014 May 6;55(6):3396-402.

    7. Lema J, Brea D, Rodriguez-Gonzalez R, Díez-Feijoo E, Sobrino T. Proteomic analysis of the tear film in patients with keratoconus. Mol Vis. 2010 Oct 13;16:2055-61.

    8. Matheis N, Grus FH, Breitenfeld M, Knych I, Funke S, Pitz S, Ponto KA, Pfeiffer N, Kahaly GJ. Proteomics differentiate between thyroid-associated orbitopathy and dry eye syndrome. Invest Ophthalmol Vis Sci. 2015 Apr;56(4):2649-56.

    9. Leonardi A, Palmigiano A, Mazzola EA, Messina A, Milazzo EM, Bortolotti M, Garozzo D. Identification of human tear fluid biomarkers in vernal keratoconjunctivitis using iTRAQ quantitative proteomics. Allergy. 2014 Feb;69(2):254-60.

    10. Kim HJ, Kim PK, Yoo HS, Kim CW. Comparison of tear proteins between healthy and early diabetic retinopathy patients. Clin Biochem. 2012 Jan;45(1-2):60-7.

    11. Pieragostino D, Agnifili L, Fasanella V, D'Aguanno S, Mastropasqua R, Di Ilio C, Sacchetta P, Urbani A, Del Boccio P. Shotgun proteomics reveals specific modulated protein patterns in tears of patients with primary open-angle glaucoma naïve to therapy. Mol Biosyst. 2013 Jun;9(6):1108-16.

    12. Böhm D, Keller K, Pieter J, Boehm N, Wolters D, Siggelkow W, Lebrecht A, Schmidt M, Kölbl H, Pfeiffer N, Grus FH. Comparison of tear protein levels in breast cancer patients and healthy controls using a de novo proteomic approach. Oncol Rep. 2012 Aug;28(2):429-38.

    13. Li B, Sheng M, Xie L, Liu F, Yan G, Wang W, Lin A, Zhao F, Chen Y. Tear proteomics analysis of patients with type 2 diabetes and dry eye syndrome by two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry. Invest Ophthalmol Vis Sci. 2014 Jan 9;55(1):177-86.

    14. Kalló G, Emri M, Varga Z, Ujhelyi B, TÅ‘zsér J, Csutak A, CsÅ‘sz É. Changes in the chemical barrier composition of tears in Alzheimer’s disease reveal potential tear diagnostic biomarkers. PLoS One. 2016 Jun 21;11(6):e0158000.

    15. Aluru SV, Shweta A, Bhaskar S, Geetha K, Sivakumar RM, Utpal T, Padmanabhan P, Angayarkanni N. Tear fluid protein changes in dry eye syndrome associated with rheumatoid arthritis: A proteomic approach. Ocul Surf. 2017 Jan;15(1):112-129.

    16. Zhou L, Beuerman KW. Tear analysis in ocular surface diseases. Prog Retin Eye Res. 2012 Nov;31(6):527-50.

    Read more from Dr. Bowling here

    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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