Kim J, et al. - Normal group and each group of three dry eye disease (DED) subtypes were compared regarding the non-invasive keratographic tear film break-up time (NIKBUT) and the location and pattern of non-invasive keratographic tear film break-up. In this study, 55 normal subjects and 250 patients with DED, who underwent tear meniscus height and NIKBUT measurements using the Keratograph 5M, were included. Compared to the normal group, lower NIKBUTs were noted in patients with aqueous-deficient dry eye disease (ADDE) and ADDE/meibomian gland dysfunction (MGD) subtypes. However, NIKBUTs did not differ between the MGD subtype and the normal group. Both the ADDE and ADDE/MGD subtypes showed a significantly higher occurrence of the first tear film break-up in the central location, comprising approximately 40% in both subtypes. In addition, the ADDE and ADDE/MGD subtypes in higher proportion showed a simultaneous multiple tear film break-up pattern, at 60.9% and 45.5%, respectively.