涙膜の動きの観察

Videographic observation of tear fluid dynamics

　瞬目に伴う角膜の涙膜油層の動的所見を検索した。一般臨床検査で異常のない外来患者50名を対象とし，男性9名，女性41名で，年齢は10歳台から70歳台である。涙膜油層の動態の観察には，非接触型のスペキュラーマイクロスコープを用い，ビデオテープに記録して解析した。まず5秒間閉瞼させ，以後は自然瞬目させ，約4分間の所見を記録した。縞模様，干渉による着色，白線が主要な所見であったが，必ずしも再現性はなかった。縮緬皺模様と局部的な着色の出没は，涙液量減少，角膜染色異常，アレルギー，コンタクトレンズ不調，眼疲労感などに多かった。これらの知見は過去の実験研究と符合することが多かった。この方法は非侵襲性で簡便であるが，これを日常の臨床に導入するには，映像を容易に取り出せる周辺機器の整備が必要である。

We observed the dynamics of lipid layer of the tear film associated with blinking. We studied 50 outpa-tients who had no problems by routine examinations. The series comprised 9 males and 41 females ranging from the second to the eighth decade in age. A noncontact specular microscope was used to observe the tear film. The findings were recorded on a videotape. The test subjects were asked to keep the eye closed for 5 seconds and the findings were recorded during the ensuing 4 minutes while they were allowed to blink freely. The major findings were stripes, color-ing by interference and white traces. Stripes simulating crushed paper and localized coloring were more frequent in eyes with decreased lacrimation, abnormal corneal staining, allergy, wear of inadequate contact lens, and fatigue. These findings were in accord with past reports. While the current method is noninvasive and easy to use, it is neces-sary to develop instruments that allow prompt access to recorded images.