Demographic information for each patient was collected, including age, sex, race, ethnicity, and health status (determined by asking patients the following question “How would you describe your current health status”? Answer choices included excellent, good, fair, or poor). Given the positive relationship between cigarette smoking and wrinkles,
11 we also evaluated the relationship between smoking status (assessed as current, previous, or never a smoker) and the presence of Cch. Dry eye symptoms were assessed via the Dry Eye Questionnaire Score 5 (DEQ5), which collects patient responses regarding tearing, dryness, and discomfort independent of visual function, and the Ocular Surface Disease Index (OSDI), which includes visual function and questions related to difficulty with daily activities such as reading, using a computer, nighttime driving, and watching television.
12,13 Patients were also asked about ocular pain severity (assessed with the numerical rating scale [NRS] scored 0–10), descriptors of eye pain (throbbing, sharpness, gnawing, hot-burning, aching, grittiness, itchiness, and irritation; all scored as present or absent), and other dry eye symptoms including sensitivity to heat, wind, light, and temperature (all scored 0–10). Moreover, the presence of individual symptoms (pain, visual complaints, and/or tearing) was recorded for each patient. This information was examined individually, as a comparison of frequencies of each symptom, and in combination, as a comparison of mean scores where each symptom received a score of 1 if present.