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Comment & Response |

Accuracy of Laboratory Assays in Ophthalmic Practice

Laura E. Downie, BOptom, PhD, PGCertOcTher, DipMus(Prac), AMusA, FACO1; Algis J. Vingrys, BSc(Optom), PhD, PGCertOcTher1
[+] Author Affiliations
1Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
JAMA Ophthalmol. 2015;133(12):1480. doi:10.1001/jamaophthalmol.2015.3856.
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To the Editor In their article titled “Variability of Tear Osmolarity in Patients With Dry Eye,” Bunya et al1 describe significant variability in TearLab osmolarity readings of clinical populations (control participants, patients with blepharitis, and patients with Sjögren syndrome) and suggest that this confounds clinical interpretation of tear osmolarity measures.

While tear hyperosmolarity is a core mechanism in dry eye disease,2 there is debate regarding whether tear osmolarity readings are sufficiently reliable for diagnosing dry eye disease.3 Variability in laboratory assays is not unique to tear osmolarity; this is a common issue for blood serum assays.4 The international collaborative study in influenza serology (H3N2 and H1N1 virus) reports a geometric coefficient of variation upper confidence limit as high as 112% for such assays; this study is useful for consideration as it involved serological assays in 7 laboratories across 5 countries.5

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December 1, 2015
Benjamin D. Sullivan, PhD; Jay S. Pepose, MD, PhD; Gary N. Foulks, MD
1TearLab Corporation, San Diego, California
2Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, Missouri
3Department of Ophthalmology and Visual Sciences, University of Louisville, Kentucky
JAMA Ophthalmol. 2015;133(12):1481-1482. doi:10.1001/jamaophthalmol.2015.3854.
December 1, 2015
James V. Aquavella, MD
1University of Rochester Flaum Eye Institute, Rochester, New York
JAMA Ophthalmol. 2015;133(12):1482-1483. doi:10.1001/jamaophthalmol.2015.3863.
December 1, 2015
Vatinee Y. Bunya, MD; Maxwell Pistilli, MEd, MS; Mina Massaro-Giordano, MD
1Scheie Eye Institute, University of Pennsylvania, Philadelphia
JAMA Ophthalmol. 2015;133(12):1480-1481. doi:10.1001/jamaophthalmol.2015.3858.
December 1, 2015
Vatinee Y. Bunya, MD; Maxwell Pistilli, MEd, MS; Gui-Shuang Ying, PhD
1Scheie Eye Institute, University of Pennsylvania, Philadelphia
JAMA Ophthalmol. 2015;133(12):1482. doi:10.1001/jamaophthalmol.2015.3860.
December 1, 2015
Vatinee Y. Bunya, MD; Nicole M. Fuerst, MD; Mina Massaro-Giordano, MD
1Scheie Eye Institute, University of Pennsylvania, Philadelphia
JAMA Ophthalmol. 2015;133(12):1483. doi:10.1001/jamaophthalmol.2015.3897.
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