title: The relation of functional visual acuity measurement methodology to tear functions and ocular surface status.
abstract: OBJECTIVE
  To investigate the relation of functional visual acuity (FVA) measurements with dry eye test parameters and to compare the testing methods with and without blink suppression and anesthetic instillation.
  
  
  METHODS
  A prospective comparative case series.
  
  
  METHODS
  Thirty right eyes of 30 dry eye patients and 25 right eyes of 25 normal subjects seen at Keio University School of Medicine, Department of Ophthalmology were studied. FVA testing was performed using a FVA measurement system with two different approaches, one in which measurements were made under natural blinking conditions without topical anesthesia (FVA-N) and the other in which the measurements were made under the blink suppression condition with topical anesthetic eye drops (FVA-BS). Tear function examinations, such as the Schirmer test, tear film break-up time, and fluorescein and Rose Bengal vital staining as ocular surface evaluation, were performed.
  
  
  RESULTS
  The mean logMAR FVA-N scores and logMAR Landolt visual acuity scores were significantly lower in the dry eye subjects than in the healthy controls (p < 0.05), while there were no statistical differences between the logMAR FVA-BS scores of the dry eye subjects and those of the healthy controls. There was a significant correlation between the logMAR Landolt visual acuities and the logMAR FVA-N and logMAR FVA-BS scores. The FVA-N scores correlated significantly with tear quantities, tear stability and, especially, the ocular surface vital staining scores.
  
  
  CONCLUSIONS
  FVA measurements performed under natural blinking significantly reflected the tear functions and ocular surface status of the eye and would appear to be a reliable method of FVA testing. FVA measurement is also an accurate predictor of dry eye status.
authors: Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Shinnjuku-ku, Tokyo, Japan.|The Johnson & Johnson Ocular Surface Visual Optics Department, Keio University School of Medicine, Tokyo, Japan.
authors: Minako
authors: M
authors: Kaido
authors: Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Shinnjuku-ku, Tokyo, Japan.
authors: Reiko
authors: R
authors: Ishida
authors: Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Shinnjuku-ku, Tokyo, Japan. muratodooru@yahoo.com.|The Johnson & Johnson Ocular Surface Visual Optics Department, Keio University School of Medicine, Tokyo, Japan. muratodooru@yahoo.com.
authors: Murat
authors: M
authors: Dogru
authors: Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Shinnjuku-ku, Tokyo, Japan.
authors: Kazuo
authors: K
authors: Tsubota
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage; D001767:Blinking / Q000502:physiology; D003941:Diagnostic Techniques, Ophthalmological; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D019793:Fluorescein; D006801:Humans; D008297:Male; D008875:Middle Aged; D011343:Procaine / Q000008:administration & dosage / Q000031:analogs & derivatives; D011446:Prospective Studies; D012395:Rose Bengal; D013666:Tears / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D012395:Rose Bengal; D011343:Procaine; C005298:benoxinate; D019793:Fluorescein