It has become increasingly apparent that bulbar conjunctival anomalies are associated with dry eye symptoms. Lissamine green (LG) and sodium fluorescein (FL) conjunctival staining were assessed in 102 soft contact lens wearers and 79 non contact lens wearers. Conjunctival staining was increased in symptomatic patients. Both LG and FL staining were discriminating factors for symptomatic non lens wearers (>or=grade 1.5, p<0.001). Only LG staining could discriminate symptomatic from asymptomatic lens wearers (>or=grade 1.0, p=0.007). This analysis confirms the involvement of the conjunctiva in dry eye symptomatology. While both stains are useful, LG shows greater specificity for symptomatic subjects, particularly in contact lens wearer. It is recommended that the examination of patients complaining of dry eyes, in particular contact lens wearing patients include as routine, the examination of the conjunctiva with lissamine green.