Cystic fibrosis is characterized by an abnormally high electrolyte concentration in exocrine secretions. The authors performed the tear mucus ferning test in 26 eyes of children with cystic fibrosis and compared the results to those in an equal number of age-matched normals. The results suggest that the increased electrolyte concentration could be responsible for the increased hyperviscosity of mucus. The tear mucus ferning test appears to be a suitable diagnostic test for the assessment of cystic fibrosis.