More work needed on method for evaluating dry eye

FORT LAUDERDALE, Fla. — The symptoms that are most bothersome to dry eye patients are not necessarily their most common symptoms, according to A. Schaberg and colleagues. Because the way dry eye patients perceive their symptoms does not always align with the way researchers measure their symptoms, more useful ways of evaluating dry eye symptoms are needed, the researchers said. They also noted that these discrepancies may affect researchers’ ability to measure the effects of treatment in dry eye trials. They reported their findings in poster presentation here at the annual meeting of the Association for Research in Vision and Ophthalmology.

Dr. Schaberg and colleagues set out to identify the usefulness of standard symptom assessments in identifying and measuring dry eye. They studied patients who were participating in a multicenter trial evaluating a dry eye treatment. At the baseline of the study and at each clinic visit, patients defined and then rated the severity of the most bothersome or worst symptom of their dry eye disease on a scale of 0 to 4. Their responses were classified into a number of defined categories, such as “affects vision,” “dryness,” “cosmetic,” and so on. Corneal and conjunctival staining and the ocular surface disease index (OSDI) were also assessed at each visit.

The “worst” symptoms reported most often among 443 patients were discomfort/pain/irritation (71%), dryness (9%), abnormal rheology (8%) and affects vision (7%).

“The mean OSDI symptom score was higher (27.4) for subjects whose worst symptom was coded as discomfort/pain/irritation or dryness than for subjects with other symptoms (23.7),” the researchers reported in their poster. “The mean OSDI visual function score was significantly greater … for the subjects whose worst symptom was coded as ‘affects vision’ compared to all others.”