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Application of a new grading scale for tear ferning in non-dry eye and dry eye subjects

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Date

2014-09-14

Authors

Masmali, Ali M.
AL-Qhtani, Sultan
Al-Gasham, Talha M.
El-Hiti, Gamal A.
Purslow, Christine
Murphy, Paul J.

Journal Title

Journal ISSN

Volume Title

Publisher

Elsevier

Abstract

Purpose: To apply the Masmali tear ferning (TF) grading scale on non-dry eye (NDE) and dry eye (DE) subjects to test the validity of the grading scale in practice, and to describe the grading scale range for NDE and DE. Method: Forty NDE subjects (20 males, 20 females) and 40 DE subjects (23 males, 17 females) ranging in age from 19 to 53 years (mean ± SD: 25.3 ± 5.5) with no other ocular disease, no contact lens wear, and not pregnant or breastfeeding were recruited. McMonnies scores were used for subject grouping. Phenol red thread (PRT) and slit-lamp test were used. A tear sample was collected from right eye, which was then dried to produce a ferning pattern, that was observed using a digital microscope, and graded. Results: Mean McMonnies, PRT and TF grade in NDE subjects were 7.1 ± 3.8, 27.4 ± 4.3 mm and 0.78 ± 0.40, respectively. Median McMonnies, PRT and TF grade in DE subjects were 16.5 ± 3.0, 9.0 ± 2.0 mm and 2.3 ± 1.48, respectively. In NDE subjects, grades 0.0–1.8 were observed (82.5% Grade 0.0–1.00). Grades 2.0–4.0 were observed in DE subjects (72.5% Grades 2.0–3.0). For all subjects, there were large correlations between TF grade and PRT (r = −0.79), PRT and McMonnies (r = −0.60), and TF and McMonnies (r = 0.73). Conclusions: The Masmali TF grading scale showed good validity in describing the TF patterns. Grades ≥2 can be classified as abnormal patterns. The TF test has the potential to be used in the clinic.

Description

The final publication is available at Elsevier via http://dx.doi.org/10.1016/j.clae.2014.09.007 © 2014. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/

Keywords

Tear ferning, Dry eye disease, Masmali grading scale, Phenol red thread test

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Citation

URI

http://hdl.handle.net/10012/11475
 http://dx.doi.org/10.1016/j.clae.2014.09.007

Collections

Waterloo Research
Optometry and Vision Science