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dc.contributor.authorMasmali, Ali M.
dc.contributor.authorAL-Qhtani, Sultan
dc.contributor.authorAl-Gasham, Talha M.
dc.contributor.authorEl-Hiti, Gamal A.
dc.contributor.authorPurslow, Christine
dc.contributor.authorMurphy, Paul J. 13:52:37 (GMT) 13:52:37 (GMT)
dc.descriptionThe final publication is available at Elsevier via © 2014. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
dc.description.abstractPurpose: 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.en
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.subjectTear ferningen
dc.subjectDry eye diseaseen
dc.subjectMasmali grading scaleen
dc.subjectPhenol red thread testen
dc.titleApplication of a new grading scale for tear ferning in non-dry eye and dry eye subjectsen
dcterms.bibliographicCitationMasmali, A. M., AL-Qhtani, S., Al-Gasham, T. M., El-Hiti, G. A., Purslow, C., & Murphy, P. J. (2015). Application of a new grading scale for tear ferning in non-dry eye and dry eye subjects. Contact Lens and Anterior Eye, 38(1), 39–43.
uws.contributor.affiliation1Faculty of Scienceen
uws.contributor.affiliation2School of Optometry and Vision Scienceen

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