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Ankit M Shah,1 Anat Galor1,2 1Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA; 2Surgical Services, Miami Veterans Affairs (VA) Medical Center, Miami, FL, USACorrespondence: Anat GalorBascom Palmer Eye Institute, 900 NW 17th St, Miami, FL, 33136, USAEmail agalor@med.miami.eduAbstract: Infrared (IR) thermographic assessment of ocular surface temperature (OST) is gaining interest as an adjuvant method to evaluate the ocular surface. It is a quick, non-invasive test that causes minimal, if any, discomfort to patients. The purpose of this article was to summarize research on how OST relates to tear film parameters and dry eye disease (DED). PubMed, Google Scholar, and Scopus searches for specific terms were carried out and eligible articles reviewed. OST of the central cornea is ∼ 34-35°C when measured as a single time-point (typically right after a blink). Dynamically, OST values decrease over time at a rate of ∼ − 0.01 °C/s in healthy eyes. Single time-point OST values are impacted by temperature, with positive correlations noted with both ambient (1°C↓ results in ∼ 0.16°C↓ in OST) and body (1°C↑ results in ∼ 0.98°C↑ in OST) temperature. Single time-point OST values are also impacted by tear parameters, with negative correlations noted with tear break-up time (TBUT; r=− 0.61) and positive correlations with lipid layer thickness (∼r=0.50). Dynamically, the rate of OST cooling over the interblink period correlates with various tear parameters including Schirmer’s test scores (r=− 0.39), tear meniscus height (r=− 0.52) and the rate of tear film break-up (r=− 0.74). These data imply that OST decreases more rapidly in individuals with greater tear production, larger tear volumes, and shorter tear break-up times (faster rates of tear film break-up). There are discrepancies in relationships between OST and DED across studies, which is not surprising given that DED encompasses a number of different phenotypic presentations. However, most studies found that OST decreases at a more rapid rate in DED vs. control groups. As such, cooling rate may have utility as a screening tool in DED in combination with established point-of-care tests.Keywords: ocular thermography, tear film, dry eye

We have summarized the past efforts and results of objective measurement methods for conjunctival hyperemia classification. Severity classification using conjunctival blood vessel occupancy rate, ocular surface temperature analysis, and artificial intelligence have been reported to be clinically useful, as they have been found to correlate with the severity of conjunctival hyperemia by doctors. The AI method using slit lamp microscope images, whose main purpose is to be widely used in daily clinical practice, can be spread all over the world. As a result, it may lay the foundation for clinical research using large amounts of clinical data collected on the same basis without human bias.