The highest prevalence rate of hepatitis C virus (HCV) infection in the world has been reported among Egyptians and up to 20 to 40% of patients chronically infected with HCV, the mode of transmission is still unknown. So the aim of this study was to detect the presence of HCV genome in the tear fluid of the patients with chronic HCV infection which may be a source of infection and to investigate the tear film function and stability in these patients. This study was done on 50 chronic active hepatitis C patients and 20 healthy subjects as a control group. The studied groups were subjected to full ophthalmological examination, liver function tests, qualitative detection of HCV-RNA in the serum and tear fluid by PCR and quantitative measurement of HCV-RNA in serum. Schirmer's test and Break Up Time (BU1) show statistically significant decreased values in patients with +ve HCV RNA in their sera, while Rose Bengal scoring test show significant increased values. These results become more pronounced in patients with
+ve HCV RNA in their tears. The viral RNA was detected by RT-PCR in the tear samples in 26 patients out of the 50 studied patients (52%) and most of cases with +ve HCV RNA in tears were associated with severe viraemia. We concluded that HCV-RNA was detected in the tear fluid quite frequently. This fluid
therefore may be potentially responsible for non-blood transmission of the hepatitis C virus. This study also indicated that HCV-RNA play a role in development of the dry eye in those patients. So we recommended screening for HCV-RNA in patients with unexplained dry eye and appropriate disi fection of equipment in ophthalmological practice to avoid viral transmission.