Comparison of tear film tests, ocular staining, impression cytology for three conditions: dry eye, anterior blepharitis, seasonal allergic conjunctivitis

Abstract

AIM: To compare three clinically similar patient groups and a control group in terms of tear function tests, ocular surface staining and conjunctival impression cytology. METHODS: This was a single-centre, prospective, double-blind, randomised and controlled trial. The study includes 20 dry eye patients with Schirmer 1 scores less than 10mm and a tear film break-up time (TBUT) less than 10s, 20 anterior blepharitis patients with drying and crusting of the eyelashes, 20 seasonal allergic conjunctivitis patients with papillary hypertrophy of the upper eyelid tarsal conjunctiva and 20 control group patients. The Schirmer scores, TBUT scores, ocular surface staining (as graded by the Oxford scheme scale), goblet cell density (as observed using impression cytology and metaplasia scores for all patients evaluated by the Nelson grading scheme) were compared. RESULTS: Significant differences were identified between these patient groups and the control group in terms of tear functions tests, ocular surface-staining scores, goblet cell density and metaplasia scores (P<0.001). CONCLUSION: Inflammatory response against these three diseases was demonstrated to cause damage in parallel to the severity of the local inflammation they generate on the ocular surface. We confirmed that this damage has very serious effects, especially on conjunctival goblet cell density and metaplasia. We believe that the degree of this loss in goblet cells is correlated with clinical findings.