A Study of Tear Ferning Patterns in Elderly Individuals with Dry Eye Disorder
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 5
Abstract
ABSTRACT Introduction: Anomalies of the mucin layer of the tear film have generally been studied in relation to contact lens users who represent a young population. Since the prevalence of dry eye increases with age and causes considerable discomfort to elderly patients, a proper assessment of tear film quality is required to facilitate a targeted approach in managing Dry Eye Disorder (DED) in older age. Aim: To study the ferning pattern of the precorneal tear film in elderly individuals and compare the results with standard tests for dry eye. Materials and Methods: A questionnaire based screened cohort of 75 individuals with DED and 75 controls, all above 50 years of age, were studied using Schirmer’s Test, Tear Break Up Time (TBUT), Lissamine green staining and ferning tests. Ferning patterns were graded by Rolando’s classification. Data were analysed by Fisher’s-exact test. Results: Dry eye tests and tear ferning were found to be abnormal in majority of the subjects who had positive scores on screening with the dry eye questionnaire. Abnormal ferning patterns (62% Grade III and 24% Grade IV) correlated significantly with positive Schirmer’s test (p≤0.001), positive TBUT test (p≤0.001) and positive Lissamine green staining (p≤0.001) of eyes with DED. Less than 14% individuals (22 eyes) exhibited Grade II ferning in the dry eye group. Greater disturbances of ferning patterns were seen with increased age. All patients above the age of 75 (n=22 eyes) with symptomatic DED had abnormal ferning. Amongst the controls, all 150 eyes, regardless of age, showed normal ferning patterns (56% Grade 1 and 44% Grade 2). Conclusion: A significant majority of elderly individuals with DED have an abnormal mucin layer in the tear film. Tear ferning test is a simple and inexpensive test and if combined with the other tear film tests may be helpful in a better assessment of DEDs, especially in the elderly. This is relevant especially for targeted treatment in cases of DED where the cause is not aqueous deficiency.
Authors and Affiliations
Amit Kumar Singh, Shubha Nagpal, Rupali Tyagi
Keywords
Related Articles
- EP ID EP522903
- DOI 10.7860/JCDR/2018/27666.11497
- Views 83
- Downloads 0
RCT on the Effect of Dexmedetomidine as an Adjuvant to Ropivacaine in Ultrasound Guided Fascia Iliaca Block for Postoperative Analgesia Following Hemi-Arthroplasty
ABSTRACT Introduction: Fascia Iliaca Compartment Block (FICB) has been employed for post-operative pain relief after hip surgeries. Dexmedetomidine has been found to prolong effect of peripheral nerve blocks but its effe...
Deep Cerebral Vein Thrombosis: A Clinical Masquerader
Cerebral Vein Thrombosis (CVT) is an uncommon cause of stroke. Thrombosis can occur in superficial veins, deep venous system or cortical veins of brain. The term Deep Cerebral Vein Thrombosis (DCVT) is used for thrombosi...
The Effect of Cavity Design on Fracture Resistance and Failure Pattern in Monolithic Zirconia Partial Coverage Restorations - An In vitro Study
Introduction: Cavity preparations of posterior teeth have been frequently associated with decreased fracture strength of the teeth. Choosing the correct indirect restoration and the cavity design when restoring the poste...
In vitro Evaluation of Resin Infiltrant Case Series Penetration into White Spot Lesions of Deciduous Molars
Introduction: Caries Infiltration is a recent microinvasive restorative technique that permits treatment of non-cavitated demineralized lesions, known as White Spot Lesions (WSL). Aim: To evaluate the extent of penetrati...
Laser Assisted Management of Telangiectatic Granuloma in Third Trimester of Pregnancy – A Case Report
Telangiectatic granuloma is an uncommon overgrowth of the tissues that occurs as a result of various stimuli such as low grade local irritation, traumatic injury or hormonal factors. It generally develops as a solitary,...