Abstract
Abstract: :
Purpose: Conjunctival folds have been reported as incidental findings in routine biomicroscopic examination, especially related to patients with dry eye disease. Our aim was to compare the incidence of temporal bulbar conjunctival folds in normal and moderately dry-eyed patients with specific biomicroscopic findings (corneal staining, limbal injection and bulbar conjunctival injection) and tear osmolality. The influence of age on these variables was also studied. Methods: Fourteen moderately dry eye subjects (12 female, 2 male; age 43.4, range 23-71 years) and eight normal subjects (3 female, 5 male; age 37.25, range 20-55 years) participated in this study. Bulbar conjunctival folds were quantified in the temporal aspect of each eye following fluorescein instillation. Tear osmolality was measured with a vapor pressure osmometer. Corneal staining, limbal and bulbar injection were assessed using the CCLRU grading scales. Left eye data were used for statistical analyses. Results: There was a slight difference in the number of bulbar conjunctival folds between the moderately dry eye group and the normal controls. (2.07 +/- 2.16 vs. 2.25 +/- 0.70, p=0.676) Conjunctival folds were not correlated with any of the above parameters nor were they associated with the age of the subject. However the study did reveal that tear osmolality (p=0.005), corneal staining (p=0.019) and conjunctival bulbar injection (p=0.016) were significantly higher in the moderately dry eye group of subjects. {Mann Whitney U Test} A significant correlation (Spearmans rho) was found between limbal injection (r2=.535, p=0.01) and corneal staining. Age was only found to be correlated with tear osmolality. (r2=.520, p=0.013) Conclusion: Although there was a small difference in the number of conjunctival folds between normals and moderately dry eye subjects, they do not appear to be as discriminating as other variables measured in the study. Additionally, age does not affect the number of conjunctival folds. Instead the study indicates that perhaps limbal injection and/or corneal staining serve as better discriminators between the two study populations.
Keywords: 376 cornea: tears/tear film/dry eye • 369 cornea: clinical science