[Lid-parallel conjunctival folds are a sure diagnostic sign of dry eye]

Dry eye syndromes are becoming more important for the ophthalmologist. Various circumstances lead to a significant impairment of the three layered precorneal film, whose disturbed equilibrium causes diverse pathological changes in the ocular surface. Apart from symptoms and clinical signs, various clinical tests and laboratory procedures can be used to confirm the diagnosis. We looked at the utility of the lid-parallel conjunctival fold (LIPCOF) with regard to the diagnosis "dry eye". In this publication we describe and classify LIPCOF, stage 0 to stage 3, and investigate its relationship to the severity of dry eye. Dryness is determined by the "sicca score", a scale between 0 and 12 based on a wide-ranging spectrum of tests, including the Schirmer I-test, tear-film break-up time, rose bengal and and fluorescein staining, the lysozyme test and impression cytology. In this prospective study we examined one eye in each of 267 patients, assigning them to one of two groups based on the absence or presence of LIPCOF. These two groups are comparable in gender and age (group-matching). For the diagnosis of dry eye, using LIPCOF, statistical analysis of the data showed a negative predictive value of 75.95% and a positive predictive value of 93.09%. The correlation pattern of LIPCOF with the patient's medical history and slit-lamp. They are a dependable diagnostic sigh of dry eye. Consideration and classification of LIPCOF enlarges and facilitates diagnosis of dry eye syndromes by the ophthalmologist.