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Reliability and utility of impression cytology in the diagnosis of dry eye
Fahad Abdullah Al Wadani1, Rajshree Nambiar2, Khalid M Abdul Wahhab3, Tariq Al Asbali4, Ajit Nambiar5, Ata Ur Rahaman6
1 Department of Surgery, College of Medicine, King Faisal University, Hofuf, Al-Hasa, Saudi Arabia
2 Kahhal Eye Centre, Al Majma’ah, Saudi Arabia
3 Assistant Professor of Ophthalmology, Majmaah University, Al Majma’ah, Saudi Arabia
4 Assistant Professor of Ophthalmology, Al-Imam University, Al Hofuf, Saudi Arabia
5 Department of Biomedical Sciences, King Faisal University, Hofuf, Al-Hasa, Saudi Arabia
6 PHC, MOH, Al Hofuf, Saudi Arabia
Correspondence Address:
Dr. Fahad Abdullah Al Wadani
Department of Ophthalmology, College of Medicine, King Faisal University, Hofuf, Al Hasa
Saudi Arabia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0189-9171.195194
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Introduction: Dry eye disease is a multifactorial disease of the tears and ocular surface that can result in ocular discomfort and visual impairment. There are numerous tests to evaluate the ocular status in dry eye disease. Among the different tests for diagnosing dry eyes, Impression Cytology is considered a practical and minimally invasive investigation. Objective: The aim of this study was to characterize ocular surface symptoms typical of dry eyes, study pattern of dry eye in various systemic diseases, assess whether impression cytology samples could be used to define conjunctival surface changes and describe changes in conjunctival cells. We also aimed to compare the sensitivity of impression cytology with other diagnostic tests. Methods: A cross sectional study was conducted among 100 patients with symptoms of dry eye. After eliciting a complete history which included any systemic disease, occupation and drug intake these patients were subjected to various tests like Schirmers test, Tear Break Up Time (TBUT), Lissamine green staining and Conjunctival impression cytology. Results: All clinical tests have limited diagnostic value if performed individually, but impression cytology showed the highest sensitivity. Conclusion: It is recommended that impression cytology is an ideal method of investigating ocular surface disorders when diagnosis is not clinically obvious or when clinical diagnosis needs substantiation. It is recommended that major ophthalmic centers should develop and introduce this technique into routine clinical practice.
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