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Abstract #127361 Published in IGR 25-3
Assessing Tear Secretory Response in Health and Disease Using a Novel i-Onion Device
Zaldivar A; Wu C; Junk A; Galor AEye Contact Lens 2025; 51: 362-367
PURPOSE: To evaluate tear secretory response using a novel device, the i-Onion, which stimulates lacrimal gland activity with concentrated CO 2 bursts. METHODS: The i-Onion device delivers a controlled CO 2 burst to the ocular surface, stimulating the lacrimal gland's tear production response. We studied 120 participants: 40 with glaucoma, 40 with cataracts (some followed postsurgery), and 40 controls. Basal tear volume (BTV) was measured using a 3-min unanesthetized the Schirmer test. Stimulated tear volume was then recorded over another 3 min after a 3-second i-Onion stimulus. Tear reserve volume (TRV), the study's primary outcome, was calculated as the difference between stimulated tear volume and BTV. RESULTS: Participants' mean age was 60.5 years; 78% male, 59% White. No significant differences in TRV were found among the groups (glaucoma: 9.3 mm; cataract: 8.3 mm; control: 7.9 mm, P =0.67) but BTV was significantly lower in patients with glaucoma and cataract compared with controls (glaucoma: 13.6 mm; cataract: 14.1 mm; control: 19.0 mm, P =0.03). Basal tear volume also decreased with age (r=-0.2, P =0.01). Presurgical TRV in patients with cataract showed a nonsignificant negative correlation with postsurgical ocular symptoms (r=-0.23, P =0.2). CONCLUSION: The i-Onion device demonstrated that TRV was preserved in elderly individuals with glaucoma and cataract, despite decreased BTV with age and disease.
Surgical Services (A.Z., C.W., A.J., A.G.), Miami Veterans Affairs Medical Center, Miami, FL; and Bascom Palmer Eye Institute (A.Z., C.W., A.J., A.G.), University of Miami, Miami, FL.
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