Year 2026,
Volume: 18 Issue: 1, 17 - 22, 24.03.2026
Ersan Ersin Demirel
,
Zarife Ekici Gök
References
-
1. Modrzejewska A. The role of thermography in ophthalmology. Ophthatherapy. 2022;9(1):14-21.
doi:10.24292/01.OT.291221.
-
2. Mapstone R. Corneal thermal patterns in anterior uveitis. Br J Ophthalmol. 1968;52(12):917-21.
doi:10.1136/bjo.52.12.917.
-
3. Mapstone R. Measurement of corneal temperature. Exp Eye Res. 1968;7(2):237-43. doi:10.1016/s0014-4835(68)80073-9.
-
4. Mapstone R. Determinants of corneal temperature. Br J Ophthalmol. 1968;52(10):729-41.
doi:10.1136/bjo.52.10.729.
-
5. Mapstone R. Normal thermal patterns in cornea and periorbital skin. Br J Ophthalmol. 1968;52(11):818-27. doi:10.1136/bjo.52.11.818.
-
6. Galassi F, Giambene B, Corvi A, Falaschi G, Menchini U. Retrobulbar hemodynamics and corneal surface temperature in glaucoma surgery. Int Ophthalmol. 2008;28(6):399-405. doi:10.1007/s10792-007-9160-8.
-
7. Jones BF. A re-appraisal of the use of infrared thermal image analysis in medicine. IEEE Trans Med Imaging. 1998;17(6):1019-27. doi:10.1109/42.746635.
-
8. Craig JP, Singh I, Tomlinson A, Morgan PB, Efron N. The role of tear physiology in ocular surface temperature. Eye. 2000;14(Pt 4):635-41. doi:10.1038/eye.2000.156.
-
9. Baudouin C, Kolko M, Melik-Parsadaniantz S, Messmer EM. Inflammation in glaucoma: from the back to the front of the eye, and beyond. Prog Retin Eye Res. 2021;83:100916. doi:10.1016/j.preteyeres.2020.100916.
-
10. Khalef N, Labib H, Helmy H, Abd El Hamid M, Moemen L, Fahmy I. Levels of cytokines in the aqueous humor of eyes with primary open angle glaucoma, pseudoexfoliation glaucoma and cataract. Electron Physician. 2017;9(2):3833-7. doi:10.19082/3833.
-
11. Weisenthal RW, Daly MK, de Freitas D, editors. 2020-2021 BCSC: basic and clinical science course, section 8: external disease and cornea. American Academy of Ophthalmology. American Academy of Ophthalmology Press; 2020.
-
12. Holmberg A. The temperature of the eye during the application of hot packs, and after milk injections. Acta Ophthalmol (Copenh). 1952;30:348–64. doi:10.1111/j.1755-3768.1952.tb00011.x.
-
13. Efron N, Young G, Brennan NA. Ocular surface temperature. Curr Eye Res. 1989;8(9):90-6.
-
14. Morgan PB, Soh MP, Efron N, Tullo AB. Potential applications of ocular thermography. Optom Vis Sci. 1993;70(7):568-76. doi:10.1097/00006324-199307000-00008.
-
15. Purslow C, Wolffsohn JS, Santodomingo-Rubido J. The effect of contact lens wear on dynamic ocular surface temperature. Cont Lens Anterior Eye. 2005;28:29-36. doi:10.1016/j.clae.2004.10.001.
-
16. Chandrasekar B, Rao AP, Murugesan M, Subramanian S, Sharath D, Manoharan U, et al. Ocular surface temperature measurement in diabetic retinopathy. Exp Eye Res. 2021;211:108749. doi:10.1016/j.exer.2021.108749.
-
17. García-Porta N, Gantes-Nuñez FJ, Tabernero J, Pardhan S. Characterization of the ocular surface temperature dynamics in glaucoma subjects using long-wave infrared thermal imaging. J Opt Soc Am A Opt Image Sci Vis. 2019;36(6):1015-21. doi:10.1364/JOSAA.36.001015.
-
18. Purslow C, Wolffsohn JS. Ocular surface temperature: a review. Eye Contact Lens. 2005;31(3):117-23. doi:10.1097/01.icl.0000141921.80061.17.
-
19. Tan JH, Ng EYK, Acharya UR, Chee C. Infrared thermography on ocular surface temperature: a review. Infrared Phys Technol. 2009;52(4):97-108. doi:10.1016/j.infrared.2009.05.002.
-
20. Ring EFJ, Ammer K. Infrared thermal imaging in medicine. Physiol Meas. 2012;33(3):R33-46. doi:10.1088/0967-3334/33/3/R33.
-
21. Tattersall GJ. Infrared thermography: a non-invasive window into thermal physiology. Comp Biochem Physiol A Mol Integr Physiol. 2016;202:78-98. doi:10.1016/j.cbpa.2016.02.022.
-
22. Alio J, Padron M. Influence of age on the temperature of the anterior segment of the eye. Measurements by infrared thermometry. Ophthalmic Res. 1982;14(3):153-9. doi:10.1159/000265187.
-
23. Freeman RD, Fatt I. Environmental influences on ocular temperature. Invest Ophthalmol. 1973;12(8):596-602.
-
24. Shah AM, Galor A. Impact of ocular surface temperature on tear characteristics: current insights. Clin Optom (Auckl). 2021;13:51-62. doi:10.2147/OPTO.S281601.
-
25. Sniegowski M, Erlanger M, Velez-Montoya R, Olson JL. Difference in ocular surface temperature by infrared thermography in phakic and pseudophakic patients. Clin Ophthalmol. 2015;9:461-6. doi:10.2147/OPTH.S69670.
-
26. Purslow C, Wolffsohn JS. The relation between physical properties of the anterior eye and ocular surface temperature. Br J Ophthalmol. 2007;84(3):197-201. doi:10.1097/OPX.0b013e3180339f6e.
-
27. Pattmöller J, Wang J, Zemova E, Seitz B, Eppig T, Langenbucher A, et al. Correlation of corneal thickness, endothelial cell density and anterior chamber depth with ocular surface temperature in normal subjects. Z Med Phys. 2015;25(3):243-50. doi:10.1016/j.zemedi.2014.09.008.
-
28. Moussa S, Eppig T, Pattmöller J, Zemova E, Seitz B, Langenbucher A, et al. Diurnal and zonal analysis of corneal surface temperature in young healthy adults. Eur J Ophthalmol. 2013;23(5):641-5. doi:10.5301/ejo.5000277.
-
29. Morgan PB, Soh MP, Efron N. Corneal surface temperature decreases with age. Cont Lens Anterior Eye. 1999;22(1):11-3. doi:10.1016/s1367-0484(99)80025-3.
-
30. Alio J, Padron M. Normal variations in the thermographic pattern of the orbito-ocular region. Diagn Imaging. 1982;51:93-8.
-
31. Kamao T, Yamaguchi M, Kawasaki S, Mizoue S, Shiraishi A, Ohashi Y. Screening for dry eye with newly developed ocular surface thermographer. Am J Ophthalmol. 2011;151(5):782-91.e1. doi:10.1016/j.ajo.2010.10.033.
-
32. Versura P, Giannaccare G, Fresina M, Campos EC. Subjective discomfort symptoms are related to low corneal temperature in patients with evaporative dry eye. Cornea. 2015;34(9):1079-85. doi:10.1097/ICO.0000000000000512.
-
33. Craig JP, Singh I, Tomlinson A, Morgan PB, Efron N. The role of physiology in ocular surface temperature. Eye (Lond). 2000;14(Pt 4):635-41. doi:10.1038/eye.2000.156.
-
34. Sodi A, Giambene B, Falaschi G, Caputo R, Innocenti B, Corvi A, et al. Ocular surface temperature in central retinal vein occlusion: preliminary data. Eur J Ophthalmol. 2007;17(5):755-9. doi:10.1177/112067210701700511.
-
35. Sodi A, Giambene B, Miranda P, Falaschi G, Corvi A, Menchini U. Ocular surface temperature in diabetic retinopathy: a pilot study by infrared thermography. Eur J Ophthalmol. 2009;19(6):1004-8. doi:10.1177/112067210901900617.
-
36. Zelichowska B, Rózycki R, Tłustochowicz M, Kujawa A, Kalicki B, Murawski P. Przydatność termografii w diagnostyce zespołu suchego oka [The usefulness of thermography in the diagnostics of dry eye syndrome]. Klin Oczna. 2005;107(7-9):483-7. Polish.
-
37. Donnenfeld ED, Olson RJ, Solomon R, Finger PT, Biser SA, Perry HD, et al. Efficacy and wound temperature gradient of WhiteStar phacoemulsification through a 1.2 mm incision. J Cataract Refract Surg. 2003;29(6):1097-100. doi:10.1016/s0886-3350(02)01917-x.
-
38. Bissen-Miyajima H, Shimmura S, Tsubota K. Thermal effect on corneal incisions with different phacoemulsification ultrasonic tips. J Cataract Refract Surg. 1999;25(1):60-4. doi:10.1016/s0886-3350(99)80012-1.
-
39. Corvi A, Innocenti B, Mencucci R. Thermography used for analysis and comparison of different cataract surgery procedures based on phacoemulsification. Physiol Meas. 2006;27(4):371-84. doi:10.1088/0967-3334/27/4/004.
-
40. Sodi A, Matteoli S, Giacomelli G, Finocchio L, Corvi A, Menchini U. Ocular surface temperature in age-related macular degeneration. J Ophthalmol. 2014;2014:281010. doi:10.1155/2014/281010.
-
41. Klamann MK, Maier AKB, Gonnermann J, Klein JP, Ruokonen P, Pleyer U. Thermography: a new option to monitor filtering bleb function? J Glaucoma. 2015;24(4):272-7. doi:10.1097/IJG.0b013e31825af0ca.
-
42. Leshno A, Stern O, Barkana Y, Kapelushnik N, Singer R, Prat DL, et al. Ocular surface temperature differences in glaucoma. Eur J Ophthalmol. 2022;32(3):1518-24. doi:10.1177/11206721211023723.
Evaluation of Ocular Surface Temperature in Glaucoma Patients Using a Non-Contact Infrared Thermometer
Year 2026,
Volume: 18 Issue: 1, 17 - 22, 24.03.2026
Ersan Ersin Demirel
,
Zarife Ekici Gök
Abstract
Aim: To evaluate the clinical relevance of ocular surface temperature (OST) measured by non-contact infrared thermometry in glaucoma patients and to determine its diagnostic performance alone and within a multivariable predictive model.
Material and Methods: In this cross-sectional study, 100 glaucoma patients and 90 healthy controls underwent comprehensive ophthalmological examination. Corneal, ocular surface, and body temperatures were measured using a non-contact infrared thermometer at a fixed 5-cm distance under controlled room temperature (25 °C). Intraocular pressure (IOP), central corneal thickness (CCT), cup-to-disc ratio, pseudoexfoliation (PEX) status, and topical antiglaucomatous treatment characteristics were recorded.
Results: Corneal and globe temperatures were significantly lower in glaucoma patients than in controls (33.38 ± 0.57 °C vs. 33.82 ± 0.68 °C and 36.09 ± 0.24 °C vs. 36.33 ± 0.35 °C; p = 0.001 for both), whereas body temperature did not differ (p = 0.605). Cup-to-disc ratio, IOP, age, and lower corneal temperature were independently associated with glaucoma, while PEX status and CCT were not significant predictors. Corneal temperature alone showed limited discriminative ability (AUC = 0.685), whereas the combined multivariable model demonstrated excellent diagnostic performance (AUC = 0.974).
Conclusion: Glaucoma is associated with significantly reduced ocular surface temperatures, which may reflect altered ocular physiology reported in glaucoma. Although OST alone has limited diagnostic utility, its integration with established clinical parameters provides strong discriminative performance. Non-contact infrared thermometry may serve as a simple, non-invasive adjunct biomarker within multiparametric glaucoma assessment and monitoring.
Ethical Statement
The study was approved by Malatya Turgut Özal University Clinical Research Ethics Committee (protocol number:2022/57) and conducted in accordance with the tenets of the Declaration of Helsinki. Written informed consent was obtained from all participants.
Supporting Institution
This research received no external funding.
Thanks
The authors thank the staff of the Department of Ophthalmology at Malatya Turgut Ozal University for their technical assistance and support.
References
-
1. Modrzejewska A. The role of thermography in ophthalmology. Ophthatherapy. 2022;9(1):14-21.
doi:10.24292/01.OT.291221.
-
2. Mapstone R. Corneal thermal patterns in anterior uveitis. Br J Ophthalmol. 1968;52(12):917-21.
doi:10.1136/bjo.52.12.917.
-
3. Mapstone R. Measurement of corneal temperature. Exp Eye Res. 1968;7(2):237-43. doi:10.1016/s0014-4835(68)80073-9.
-
4. Mapstone R. Determinants of corneal temperature. Br J Ophthalmol. 1968;52(10):729-41.
doi:10.1136/bjo.52.10.729.
-
5. Mapstone R. Normal thermal patterns in cornea and periorbital skin. Br J Ophthalmol. 1968;52(11):818-27. doi:10.1136/bjo.52.11.818.
-
6. Galassi F, Giambene B, Corvi A, Falaschi G, Menchini U. Retrobulbar hemodynamics and corneal surface temperature in glaucoma surgery. Int Ophthalmol. 2008;28(6):399-405. doi:10.1007/s10792-007-9160-8.
-
7. Jones BF. A re-appraisal of the use of infrared thermal image analysis in medicine. IEEE Trans Med Imaging. 1998;17(6):1019-27. doi:10.1109/42.746635.
-
8. Craig JP, Singh I, Tomlinson A, Morgan PB, Efron N. The role of tear physiology in ocular surface temperature. Eye. 2000;14(Pt 4):635-41. doi:10.1038/eye.2000.156.
-
9. Baudouin C, Kolko M, Melik-Parsadaniantz S, Messmer EM. Inflammation in glaucoma: from the back to the front of the eye, and beyond. Prog Retin Eye Res. 2021;83:100916. doi:10.1016/j.preteyeres.2020.100916.
-
10. Khalef N, Labib H, Helmy H, Abd El Hamid M, Moemen L, Fahmy I. Levels of cytokines in the aqueous humor of eyes with primary open angle glaucoma, pseudoexfoliation glaucoma and cataract. Electron Physician. 2017;9(2):3833-7. doi:10.19082/3833.
-
11. Weisenthal RW, Daly MK, de Freitas D, editors. 2020-2021 BCSC: basic and clinical science course, section 8: external disease and cornea. American Academy of Ophthalmology. American Academy of Ophthalmology Press; 2020.
-
12. Holmberg A. The temperature of the eye during the application of hot packs, and after milk injections. Acta Ophthalmol (Copenh). 1952;30:348–64. doi:10.1111/j.1755-3768.1952.tb00011.x.
-
13. Efron N, Young G, Brennan NA. Ocular surface temperature. Curr Eye Res. 1989;8(9):90-6.
-
14. Morgan PB, Soh MP, Efron N, Tullo AB. Potential applications of ocular thermography. Optom Vis Sci. 1993;70(7):568-76. doi:10.1097/00006324-199307000-00008.
-
15. Purslow C, Wolffsohn JS, Santodomingo-Rubido J. The effect of contact lens wear on dynamic ocular surface temperature. Cont Lens Anterior Eye. 2005;28:29-36. doi:10.1016/j.clae.2004.10.001.
-
16. Chandrasekar B, Rao AP, Murugesan M, Subramanian S, Sharath D, Manoharan U, et al. Ocular surface temperature measurement in diabetic retinopathy. Exp Eye Res. 2021;211:108749. doi:10.1016/j.exer.2021.108749.
-
17. García-Porta N, Gantes-Nuñez FJ, Tabernero J, Pardhan S. Characterization of the ocular surface temperature dynamics in glaucoma subjects using long-wave infrared thermal imaging. J Opt Soc Am A Opt Image Sci Vis. 2019;36(6):1015-21. doi:10.1364/JOSAA.36.001015.
-
18. Purslow C, Wolffsohn JS. Ocular surface temperature: a review. Eye Contact Lens. 2005;31(3):117-23. doi:10.1097/01.icl.0000141921.80061.17.
-
19. Tan JH, Ng EYK, Acharya UR, Chee C. Infrared thermography on ocular surface temperature: a review. Infrared Phys Technol. 2009;52(4):97-108. doi:10.1016/j.infrared.2009.05.002.
-
20. Ring EFJ, Ammer K. Infrared thermal imaging in medicine. Physiol Meas. 2012;33(3):R33-46. doi:10.1088/0967-3334/33/3/R33.
-
21. Tattersall GJ. Infrared thermography: a non-invasive window into thermal physiology. Comp Biochem Physiol A Mol Integr Physiol. 2016;202:78-98. doi:10.1016/j.cbpa.2016.02.022.
-
22. Alio J, Padron M. Influence of age on the temperature of the anterior segment of the eye. Measurements by infrared thermometry. Ophthalmic Res. 1982;14(3):153-9. doi:10.1159/000265187.
-
23. Freeman RD, Fatt I. Environmental influences on ocular temperature. Invest Ophthalmol. 1973;12(8):596-602.
-
24. Shah AM, Galor A. Impact of ocular surface temperature on tear characteristics: current insights. Clin Optom (Auckl). 2021;13:51-62. doi:10.2147/OPTO.S281601.
-
25. Sniegowski M, Erlanger M, Velez-Montoya R, Olson JL. Difference in ocular surface temperature by infrared thermography in phakic and pseudophakic patients. Clin Ophthalmol. 2015;9:461-6. doi:10.2147/OPTH.S69670.
-
26. Purslow C, Wolffsohn JS. The relation between physical properties of the anterior eye and ocular surface temperature. Br J Ophthalmol. 2007;84(3):197-201. doi:10.1097/OPX.0b013e3180339f6e.
-
27. Pattmöller J, Wang J, Zemova E, Seitz B, Eppig T, Langenbucher A, et al. Correlation of corneal thickness, endothelial cell density and anterior chamber depth with ocular surface temperature in normal subjects. Z Med Phys. 2015;25(3):243-50. doi:10.1016/j.zemedi.2014.09.008.
-
28. Moussa S, Eppig T, Pattmöller J, Zemova E, Seitz B, Langenbucher A, et al. Diurnal and zonal analysis of corneal surface temperature in young healthy adults. Eur J Ophthalmol. 2013;23(5):641-5. doi:10.5301/ejo.5000277.
-
29. Morgan PB, Soh MP, Efron N. Corneal surface temperature decreases with age. Cont Lens Anterior Eye. 1999;22(1):11-3. doi:10.1016/s1367-0484(99)80025-3.
-
30. Alio J, Padron M. Normal variations in the thermographic pattern of the orbito-ocular region. Diagn Imaging. 1982;51:93-8.
-
31. Kamao T, Yamaguchi M, Kawasaki S, Mizoue S, Shiraishi A, Ohashi Y. Screening for dry eye with newly developed ocular surface thermographer. Am J Ophthalmol. 2011;151(5):782-91.e1. doi:10.1016/j.ajo.2010.10.033.
-
32. Versura P, Giannaccare G, Fresina M, Campos EC. Subjective discomfort symptoms are related to low corneal temperature in patients with evaporative dry eye. Cornea. 2015;34(9):1079-85. doi:10.1097/ICO.0000000000000512.
-
33. Craig JP, Singh I, Tomlinson A, Morgan PB, Efron N. The role of physiology in ocular surface temperature. Eye (Lond). 2000;14(Pt 4):635-41. doi:10.1038/eye.2000.156.
-
34. Sodi A, Giambene B, Falaschi G, Caputo R, Innocenti B, Corvi A, et al. Ocular surface temperature in central retinal vein occlusion: preliminary data. Eur J Ophthalmol. 2007;17(5):755-9. doi:10.1177/112067210701700511.
-
35. Sodi A, Giambene B, Miranda P, Falaschi G, Corvi A, Menchini U. Ocular surface temperature in diabetic retinopathy: a pilot study by infrared thermography. Eur J Ophthalmol. 2009;19(6):1004-8. doi:10.1177/112067210901900617.
-
36. Zelichowska B, Rózycki R, Tłustochowicz M, Kujawa A, Kalicki B, Murawski P. Przydatność termografii w diagnostyce zespołu suchego oka [The usefulness of thermography in the diagnostics of dry eye syndrome]. Klin Oczna. 2005;107(7-9):483-7. Polish.
-
37. Donnenfeld ED, Olson RJ, Solomon R, Finger PT, Biser SA, Perry HD, et al. Efficacy and wound temperature gradient of WhiteStar phacoemulsification through a 1.2 mm incision. J Cataract Refract Surg. 2003;29(6):1097-100. doi:10.1016/s0886-3350(02)01917-x.
-
38. Bissen-Miyajima H, Shimmura S, Tsubota K. Thermal effect on corneal incisions with different phacoemulsification ultrasonic tips. J Cataract Refract Surg. 1999;25(1):60-4. doi:10.1016/s0886-3350(99)80012-1.
-
39. Corvi A, Innocenti B, Mencucci R. Thermography used for analysis and comparison of different cataract surgery procedures based on phacoemulsification. Physiol Meas. 2006;27(4):371-84. doi:10.1088/0967-3334/27/4/004.
-
40. Sodi A, Matteoli S, Giacomelli G, Finocchio L, Corvi A, Menchini U. Ocular surface temperature in age-related macular degeneration. J Ophthalmol. 2014;2014:281010. doi:10.1155/2014/281010.
-
41. Klamann MK, Maier AKB, Gonnermann J, Klein JP, Ruokonen P, Pleyer U. Thermography: a new option to monitor filtering bleb function? J Glaucoma. 2015;24(4):272-7. doi:10.1097/IJG.0b013e31825af0ca.
-
42. Leshno A, Stern O, Barkana Y, Kapelushnik N, Singer R, Prat DL, et al. Ocular surface temperature differences in glaucoma. Eur J Ophthalmol. 2022;32(3):1518-24. doi:10.1177/11206721211023723.