Masmali and Rolando Scales in Distinct Brachycephalic Dogs: Healthy or Unhealthy Tears?

To evaluate and compare Tear Ferning Test (TFT) grades among French Bulldogs, Pugs, and Shih Tzus; to determine the inter-observer agreement for subjective TFT grading; and to assess the association between subjective TFT classification and quantitative stereological analysis using Stepanizer.

Seventy-five healthy brachycephalic dogs (150 eyes; 25 French Bulldogs, 25 Pugs, 25 Shih Tzus) underwent standard ophthalmic exams. These included Schirmer Tear Test-1 (STT-1), tear film break-up time (TBUT), and Rose Bengal dyeing. TFT results were classified as healthy or unhealthy using the Masmali and Rolando scales. These results were correlated with Stepanizer point counts via linear regression. Interbreed comparisons were performed.

TFT grades did not differ among breeds. The Masmali scale, compared to the Rolando scale, identified a higher number of unhealthy eyes across all groups (p < 0.01). Both the Masmali and Rolando scales showed significant associations with Stepanizer point counts (p < 0.0001), but the association was stronger for the Rolando scale.

Both the Masmali and Rolando scales enabled classification of tears as healthy or unhealthy and were associated with stereological analysis. The stereological tool showed a stronger association with the Rolando scale than with the Masmali scale. Use of the Rolando scale with Step points may provide a more objective TFT interpretation and reduce subjectivity in clinical practice.