The association of bulbar conjunctival folds with other clinical findings in normal and moderate dry eye subjects.

BACKGROUND

Conjunctival folds have been reported as incidental findings in routine biomicroscopic examination, especially related to patients with dry eye disease. We compared the number of lower temporal lid-parallel conjunctival folds (LIPCOF) in normal and moderate dry-eyed patients with specific biomicroscopic findings (corneal staining, limbal injection, and bulbar conjunctival injection) and tear osmolality.

METHODS

Fourteen moderate dry eye subjects (12 female, 2 male; mean age, 43.4 years--range, 23 to 71 years) and eight normal subjects (3 female, 5 male; mean age, 37.25 years--range, 20 to 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.

RESULTS

There was a slight difference in the number of bulbar conjunctival folds between the moderate 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 moderate dry eye group of subjects (Mann Whitney U Test). A significant correlation (Spearmans rho) was found between limbal injection (r2 = 0.535, p = 0.01) and comeal staining. Age was only found to be correlated with tear osmolality (r2 = 0.520, p = 0.013).

CONCLUSIONS

Although there was a small difference in the number of conjunctival folds between normal and moderate 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.