Spectral domain optical coherence tomography for measuring tear film meniscus height and its relationship with epiphora

Purpose: To evaluate the relationship between tear meniscus height (TMH) values measured by optical coherence tomography (OCT) and the severity of epiphora (Munk scoring). Methods: In this prospective cross-sectional study, consecutive patients with epiphora were studied. All patients underwent Munk epiphora scoring, lacrimal syringing, and detailed ophthalmological examination. Using OCT, the TMH (i.e., the line intersecting level of tear meniscus and lower eyelid) values were calculated. The relationship between TMH and epiphora was analyzed by comparing TMH values across various grades of epiphora using Kruskal–Wallis test. Results: A total of 38 patients (56 eyes) were included. The mean age was 55 ± 11.1 years with equal distribution of males and females. The mean TMH values were 238 ± 141.3, 396.6 ± 159.5, 707.1 ± 288.8, and 809.5 ± 419.4 μm in grades 1, 2, 3, and 4 of epiphora, respectively. A significant difference in TMH was found among grades 2, 3, and 4 (P = 0.0007). On post hoc analysis, only grade 2 was significantly different from grades 3 and 4 (P = 0.0008 and P = 0.002 respectively), but grades 3 and 4 were comparable (P = 0.62). Conclusion: Levels of TMH were found to increase with increasing severity of epiphora. TMH values were comparable in Munk grades 3 and 4