Diagnostic tools allow clinicians the opportunity to effectively assess the underlying cause and diagnose dry eye earlier in the disease process.
For nearly 16 million Americans, dry eye disease (DED) is a reality, and these numbers continue to increase.1
While the definition of the disease is agreed upon in medical circles, its diagnoses is a little less in focus, due in large part to its underlying cause is often multifactorial and complex. There also is no single “gold standard” test for dry eye. Its diagnosis is based on a combination of tests and patient-reported symptoms.
The good news for patients today is that diagnostic tools are improving, allowing clinicians to better determine the underlying cause and diagnose dry eye earlier in the disease process.
There is an inconsistent correlation between patient-reported symptoms and clinical signs of DED.2 One study found that one in three patients with moderate to severe symptoms had no surface staining.3 Further, physicians often underestimate dry eye severity compared with patient perception, making symptom questionnaires an important tool when diagnosing DED.
A number of questionnaires are available, including the Ocular Surface Disease Index, Dry Eye Questionnaire 5, McMonnies, and the Standard Patient Evaluation of Eye Dryness (SPEED).
Each questionnaire has its strengths, but Ngo et. al found SPEED to be the most repeatable and valid questionnaire compared to the other surveys available.4
1. Dana R, Bradley JL, Guerin A, et al. Estimated Prevalence and Incidence of Dry Eye Disease Based on Coding Analysis of a Large, All-age United States Health Care System. Am J Ophthalmol. 2019;202:47-54.
2. Schein OD, Tielsch JM, Munoz B, et al. Relation between signs and symptoms of dry eye in the elderly. A population-based perspective. Ophthalmology. 1997;104(9):1395-401.
3. Begley CG, Chalmers RL, Abetz L, et al. The relationship between habitual patient-reported symptoms and clinical signs among patients with dry eye of varying severity. Invest Ophthalmol Vis Sci. 2003;44(11):4753-61.
4. Ngo W, Situ P, Keir N, et al. Psychometric properties and validation of the Standard Patient Evaluation of Eye Dryness questionnaire. Cornea. 2013;32(9):1204-10.
5. Vashisht S, Singh S. Evaluation of Phenol Red Thread test versus Schirmer test in dry eyes: A comparative study. Int J Appl Basic Med Res. 2011;1(1):40-2.
6. Sweeney DF, Millar TJ, Raju SR. Tear film stability: a review. Exp Eye Res. 2013;117:28-38.
7. Craig JP, Nelson JD, Azar DT, et al. TFOS DEWS II Report Executive Summary. Ocul Surf. 2017;15(4):802-12.