In vivo thickness dynamics measurement of tear film lipid and aqueous layers with optical coherence tomography and maximum-likelihood estimation.

Dry eye disease (DED) is a common ophthalmic condition that is characterized by tear film instability and leads to ocular surface discomfort and visual disturbance. Advancements in the understanding and management of this condition have been limited by our ability to study the tear film secondary to its thin structure and dynamic nature. Here, we report a technique to simultaneously estimate the thickness of both the lipid and aqueous layers of the tear film in vivo using optical coherence tomography and maximum-likelihood estimation. After a blink, the lipid layer was rapidly thickened at an average rate of 10 nm/s over the first 2.5 s before stabilizing, whereas the aqueous layer continued thinning at an average rate of 0.29 µm/s of the 10 s blink cycle. Further development of this tear film imaging technique may allow for the elucidation of events that trigger tear film instability in DED.