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Tear mucus ferning patterns in the diagnosis and management of dry eye syndrome: A comparison between the ocular surface disease index questionnaire, as a subjective test, and tear mucus ferning patterns, as an objective test

1 May 2005


Dry eye syndrome (DES) is a very common ocular morbidity in the U.S. and eye care professionals should have a deep knowledge of its pathophysiology. No objective tests have been found that correlate well with subjective symptoms. Because of this, we wanted to see if tear mucus ferning patterns (TMFPs) correlated with subjective symptoms as measured with the ocular surface disease index (OSDI) questionnaire. We collected tear samples and got questionnaires filled out from the same participants in October-November and then April-May. When considering both sessions together, 47 out of 55 or 85.45% of our participants had symptoms and 20 of those 47 or 42.55% had an abnormal TMFP. A stronger correlation between an objective test and subjective measurements than any studies we have found. However, in our statistical analysis, the two tests were not predictive of one another (1st session Spearman rho= -0.1392 and 2nd session Spearman rho= +0.2055). The analysis shows that TMFPs are not the test to diagnose DES, but that it is a good objective tool that should be used to assist with diagnosis. It should be noted that abnormal TMFPs are an indication of tear film mucus layer deficiency/pathology and is only one of many potential causes of DES.


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