The Dry Eye Zone

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Abstract: Lid-parallel conjunctival folds

The study was designed to test the clinical application of the grading of lid-parallel conjunctival folds (LIPCOF) as a diagnostic test for dry eye.
At 12 centres in 11 countries, 272 eyes of 272 dry eye patients (75 men, 197 women) were examined. Their mean age was 52.7±16.2 years. The LIPCOF were graded according to the method of Höh et al. The tear film break-up time (BUT) was measured, and fluorescein staining and the Schirmer 1 test were performed. The subjective symptoms were evaluated by 16 questions.
The LIPCOF score demonstrated significant positive correlations with age, dry eye disease severity and fluorescein staining (r> 0.2, p< 0.001), and negative correlations with BUT and results of the Schirmer 1 test (r< -0.2, p< 0.001). The LIPCOF score exhibited a significant correlation with the overall subjective symptoms (r=0.250, p< 0.001). The sensitivity and specificity of LIPCOF grading for discriminating between normal and dry eyes were best with the cut-off between LIPCOF degrees 1 and 2.
The displayed medium sensitivity and specificity, and good positive predictive value of the LIPCOF test support the use of LIPCOF grading as a simple, quick and non-invasive dry eye screening tool.

Br J Ophthalmol. 2012 Sep 5. [Epub ahead of print]
Németh J, Fodor E, Lang Z, Kosina-Hagyó K, Berta A, Komár T, Petricek I, Higazy M, Prost M, Grupcheva C, Kemer OE, Schollmayer P, Samaha A, Hlavackova K.
Semmelweis University, Budapest, Hungary.