ArticleOphthalmology and therapy2026
Corneal Sensitivity with the Non-contact Esthesiometer as Compared to the Cotton Wisp Test in Patients with Ocular Surface Diseases.
Article in Ophthalmology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Making Corneal Sensation Testing Accessible: Bench Validation of a Low-Cost Adjustable Monofilament Aesthesiometer.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026Article
- Management of Stage 1 Neurotrophic Keratopathy with Shelf-Stable, Cryopreserved Amniotic Membrane: A Retrospective Study.Clinical ophthalmology (Auckland, N.Z.) · 2026Article
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Authors and funding
6 authors.
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Abstract
introductionIntact corneal sensation plays a vital role in maintaining ocular surface health. Various ocular surface pathologies can present with differing levels of decreased corneal sensation, while in some cases patients may instead experience heightened sensation. This study compared corneal sensitivity with the new quantitative non-contact esthesiometer (NCE, Brill, USA) and the conventional qualitative cotton wisp (CW) test in patients with ocular surface diseases (OSD).
methodsA retrospective, cross-sectional study was conducted, including patients with OSDs, who had both CW and NCE test results available. Descriptive analysis of one eye per patient was performed to compare the distribution of patients according to NCE and CW responses.
resultsOf 139 eyes (n = 139 patients), 129 (92.8%) were CW+ and 10 eyes were CW- (7.2%). Among these, 111 eyes responded to levels 1-3 when assessed with NCE, with 38 (34.2%) responding to level 1, 45 (40.5%) to level 2, and 28 (25.2%) to level 3. However, of CW+ eyes, 10 (7.8%) responded to level 4 and 6 (4.7%) responded to level 5 of NCE, while 2 (1.6%) had no response to any NCE stimulation (i.e., level 6), indicating varying degrees of hyposensitivity not detected by CW. Of the 10 eyes (7.2%) that did not respond to CW (CW-), 3 responded to level 4, and one to level 5 of NCE, while 4 eyes (40.0%) failed to respond to NCE (level 6). Notably, two CW- patients responded to level 1 NCE, suggesting potential hypersensitivity. Results showed high sensitivity (98.2%, 95% CI 93.8-99.8%) but low specificity (30.8%, 95% CI 14.3-51.8%) of the CW test in patients with OSD when level 4 of NCE (i.e., levels 4, 5, and 6) was used as the cutoff for defining corneal hyposensitivity.
conclusionOur results demonstrate that the low specificity of the qualitative CW test, combined with a broad confidence interval, indicates a high likelihood of false-positive results. This suggests that a positive CW test may not reliably rule out hyposensitivity, underscoring the need for further evaluation in the setting of a positive CW test result.
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