“…In addition, all patients underwent tear film assessment including (1) tear osmolarity (TearLAB, San Diego, California, USA) (once in each eye), (2) tear breakup time (5 µL fluorescein placed, three measurements taken in each eye and averaged), (3) corneal staining (NEI scale, five areas of cornea assessed),15 (4) Schirmer testing with anaesthesia and (5) eyelid and meibomian gland assessment 16. Eyelid vascularity was graded on a scale of 0–3 (0, none; 1, mild telangiectasias; 2, moderate telangiectasias; 3, severe telangiectasias) as was meibomian gland plugging (0, none; 1, less than a third of lower eyelid margin; 2, 1/3 to 2/3 of eyelid margin; 3, >2/3 of eyelid margin).…”