Correlations between commonly used objective signs and symptoms for the diagnosis of dry eye disease: clinical implications
Benjamin Sullivan,Leslie Crews,Elisabeth M. Messmer,Gary N. Foulks,Kelly K. Nichols,Philipp B. Baenninger,Gerd Geerling,Francisco C Figueiredo,Michael A. Lemp,Michael A. Lemp +9 more
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TLDR
Evaluation of the relationship between signs and symptoms of dry eye disease in a clinic‐based population and its impact on quality of life in a hospital-based population is conducted.Abstract:
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Purpose: To evaluate the relationship between signs and symptoms of dry eye disease (DED) in a clinic-based population.
Methods: In a retrospective analysis, clinical signs and symptoms were evaluated for 344 subjects (n = 82, normal; n = 263, dry eye), across 11 sites from the EU and United States. Pearson correlations between signs and symptoms (r2) and an independent components analysis (ICA) mixing matrix were derived from the data set. Similar analysis was performed on an independent data set from 200 subjects in a previous study in Munich, Germany.
Results: No correlations above r2 = 0.17 were found between any signs and symptoms, except for corneal and conjunctival staining, which reported an r2 = 0.36. In the multisite study, the average r2 for osmolarity (0.07), tear breakup time (0.12), Schirmer test (0.09), corneal (0.16) and conjunctival staining (0.17), meibomian grading (0.11) and Ocular Surface Disease Index® (0.11) were consistently low. Among patients who showed evidence of DED by consensus of clinical signs, only 57% reported symptoms consistent with a diagnosis of DED. Similar results were observed in the Munich-based study data set. Each component of the ICA mixing matrix exhibited minimal residual information.
Conclusions: No consistent relationship was found between common signs and symptoms of DED. Each type of measurement provides distinct information about the condition of the ocular surface. These results also demonstrate that symptoms alone are insufficient for the diagnosis and management of DED and argue for a consensus of clinical signs that better reflect all aspects of the disease.read more
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Journal ArticleDOI
TFOS DEWS II Epidemiology Report.
Fiona Stapleton,Monica Alves,Vatinee Y Bunya,Isabelle Jalbert,Kaevalin Lekhanont,Florence Malet,Kyung Sun Na,Debra A. Schaumberg,Miki Uchino,Jelle Vehof,Eloy Viso,Susan Vitale,Lyndon Jones +12 more
TL;DR: The subcommittee reviewed the prevalence, incidence, risk factors, natural history, morbidity and questionnaires reported in epidemiological studies of dry eye disease and confirmed that prevalence increases with age, however signs showed a greater increase per decade than symptoms.
Journal ArticleDOI
TFOS DEWS II Diagnostic Methodology report
James S. Wolffsohn,Reiko Arita,Robin L. Chalmers,Ali R. Djalilian,Murat Dogru,Kathy Dumbleton,Preeya K. Gupta,Paul M. Karpecki,Sihem Lazreg,Heiko Pult,Benjamin Sullivan,Alan Tomlinson,Louis Tong,Edoardo Villani,Kyung Chul Yoon,Lyndon Jones,Jennifer P. Craig +16 more
TL;DR: The role of the Tear Film and Ocular Surface Society (TFOS) Dry Eye Workshop (DEWS) II Diagnostic Methodology Subcommittee was to identify tests used to diagnose and monitor dry eye disease (DED) to identify those most appropriate to fulfil the definition of DED and its sub-classifications.
Journal ArticleDOI
TFOS DEWS II Tear Film Report
Mark D. P. Willcox,Pablo Argüeso,Georgi As. Georgiev,Juha M. Holopainen,Gordon W. Laurie,Tom J. Millar,Eric B. Papas,Jannick P. Rolland,Tannin A. Schmidt,Ulrike Stahl,Tatiana Suarez,Lakshman N. Subbaraman,Ömür Ö. Uçakhan,Lyndon Jones +13 more
TL;DR: The members of the Tear Film Subcommittee reviewed the role of the tear film in dry eye disease (DED), biophysical and biochemical aspects of tears and how these change in DED and recommended areas for future research.
Journal ArticleDOI
TFOS DEWS II pain and sensation report
Carlos Belmonte,Jason J. Nichols,Stephanie Cox,James A. Brock,Carolyn G. Begley,David A. Bereiter,Darlene A. Dartt,Anat Galor,Anat Galor,Pedram Hamrah,Jason J. Ivanusic,Deborah S. Jacobs,Nancy A. McNamara,Nancy A. McNamara,Mark I. Rosenblatt,Fiona Stapleton,James S. Wolffsohn +16 more
TL;DR: Pain associated with mechanical, chemical, and thermal heat stimulation of the ocular surface is mediated by trigeminal ganglion neurons, while cold thermoreceptors detect wetness and reflexly maintain basal tear production and blinking rate, thereby evoking dryness sensations and pain.
Journal ArticleDOI
The pathophysiology, diagnosis, and treatment of dry eye disease.
TL;DR: The treatment of dry eye has evolved from tear substitution alone to a rationally based therapeutic algorithm and currently focuses on pathophysiology, new diagnostic techniques, and novel therapies including secretagogues, topical androgens, and new anti- inflammatory drugs.
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Tear osmolarity in the diagnosis and management of dry eye disease
Michael A. Lemp,Anthony J. Bron,Christophe Baudouin,Jose M. Benitez del Castillo,David Geffen,Joe Tauber,Gary N. Foulks,Jay S. Pepose,Benjamin Sullivan +8 more
TL;DR: Tear osmolarity is the best single metric both to diagnose and classify dry eye disease and intereye variability is a characteristic of dry eye not seen in normal subjects.