RT Journal Article
A1 Valikodath, Nita
A1 Newman-Casey, Paula Anne
A1 Niziol, Leslie
A1 Woodward, Maria A
T1 Patient Self-Reported Questionnaire for Eye Complaints To Identify Anterior Segment Pathology
JF Investigative Ophthalmology & Visual Science
JO Invest. Ophthalmol. Vis. Sci.
YR 2016
VO 57
IS 12
SP 6224
OP 6224
SN 1552-5783
AB    To validate a questionnaire to assess eye complaints that can detect the presence of anterior segment (AS) pathology and facilitate patient self-triage.    The content of the Patient Ocular Symptom Telemedicine Questionnaire (POST) was created using existing validated questionnaires (NEI-VFQ, OSDI). Content validity was assessed by expert review (10 MDs) and evaluated with 40 patients prior to this study. The questionnaire included 9 eye symptom items. Patients from the comprehensive and cornea clinics were recruited to complete the POST. An ophthalmologist performed a complete exam on all participants. Presence of AS disease was analyzed by logistic regression and the number of reported symptoms by Poisson regression.    74 subjects (148 eyes) were enrolled. In normal eyes (n=28), 79% reported no symptoms on the POST. In eyes with AS diagnoses (n=120), 72% reported ≥1 symptom on the POST. The predicted number of reported symptoms in eyes with an AS diagnosis was 3.3 times higher than that of normal eyes (relative risk, RR=3.29, 95% confidence interval, CI=1.34-8.08, p=0.01). Eyes with symptoms of pain, glare, sensitivity to light, and blurred vision were associated with increased odds of AS disease, compared to eyes without these symptoms (unadjusted odds ratio, OR=8.85, 10.18, 3.58, 10.15, respectively; all p<0.05) but symptoms of burning, itching, gritty feeling, redness, or headache were not (all p≥0.05). In a multivariable model, symptoms of glare (adjusted OR=5.78, CI=1.64-20.36, p<0.01) and blurred vision (adjusted OR=5.42, CI=1.56-18.84, p<0.01) were independently predictive of increased odds of AS disease, compared to eyes without these symptoms. In eyes with infectious keratitis (INFK) (n=24), 83% were reported to have ≥ 1 symptom and 58% with ≥ 5 symptoms. The predicted number of reported symptoms in eyes with INFK was 8 times higher than that of normal eyes (RR=8.34, CI=3.00-23.20, p<0.001). INFK eyes had between 8-45 times increased odds of a reported symptom compared to normal eyes (all p<0.02).    Patients whose eyes have AS problems can self-report ocular symptoms accurately compared with normal eyes. Symptoms of pain, glare, sensitivity to light, and blurred vision predict the presence of AS pathology. The POST could serve as a screening tool to enhance remote evaluation of ophthalmic complaints in a telemedicine setting.  This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016. 
RD 1/21/2021