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Journal of Ophthalmology
Volume 2016, Article ID 8154315, 5 pages
Research Article

Assessment of Tear Film Quality among Smokers Using Tear Ferning Patterns

Cornea Research Chair, Department of Optometry, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia

Received 23 August 2016; Revised 19 October 2016; Accepted 31 October 2016

Academic Editor: Jesús Pintor

Copyright © 2016 Ali M. Masmali et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To investigate the effect of cigarette smoking on the ocular tear film. Methods. Thirty healthy young male cigarette smokers (20–38 years old) and 30 healthy age matched nonsmokers were enrolled in the study. McMonnies questionnaire, slit lamp, and PRT test were used to screen the subjects. Tear samples were collected from the right eyes and tear ferning patterns were observed and graded. Results. The mean MacMonnies scores and TF grades were significantly higher in the smoker subjects (mean ± SD = and , resp.) compared to nonsmokers (mean ± SD = and , resp.). The mean values obtained from PRT and TBUT tests were  mm and for smokers and  mm and for nonsmokers, respectively. Strong correlations were found between MacMonnies scores and both PRT () and TF (). There was statistically significant difference in TF grades (), TBUT () and McMonnies () between smokers and nonsmokers. Conclusion. Cigarette smoking could have a significant effect on the tear film quality of the eye.