Good tear quality is fundamental for the health of the ocular structures that are exposed to the outer world such as the cornea and the conjunctiva. Deficiency of tear quantity and quality would lead to increased infections, decreased transparency of cornea, irritation, and in severe cases dry eye disease (DED). Naturally a number of factors affect the production and chemical constitution of the tear film, and gender seems to be one such factor that might affect the tear quality, especially in the tear fern patterns. As the ferning patters are very much dependent of the chemical constitution of the tear film and are susceptible to hormonal changes in humans. Although previous studies have shown no difference on tern fern patters between genders, but these studies had very small sample size. So, in our study we measured the tear break up time [TBUT], Schirmer’s, and grades of stimulated and unstimulated tear ferning patters for 120 participants (60 Males, 60 Females), to see if there are quantitative difference between genders. We found that tear film stability as measured by TBUT may be influenced by age, but not gender. TBUT increased significantly from young to middle-aged individuals, but then remains stable between middle-aged and old individuals. Similarly, the Schirmer’s test results showed a significant difference in tear production between young and middle-aged groups and young and older age groups, but no significant difference between middle-aged and older age groups. And, the tear-ferning test showed that gender had a significant effect on tear ferning grades, with a larger proportion of males having poorer tear film quality compared to females. This study provides valuable insight into the effect of gender and age on tear film stability and production in Indian subjects.

Keywords : Tear Breakup Time [TBUT], Schirmer’s Test, Tear Ferning Pattern, Stimulated Tears, Unstimulated Tears.