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P.A. Parry, C. Teale, D.E. Irwin, C.T. Burk, M.S. Figueiredo, F.C. Figueiredo; The Clinical and Quality of Life Outcomes of Managing Patients with Keratoconjunctivitis Sicca . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3454.
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Purpose: To evaluate the current management of dry eye disease in relation to both clinical and patient reported quality of life outcomes in Keratoconjunctivitis Sicca (KCS) patients. Methods: This was a prospective, single–center, selectively enrolled registry of adult patients in Newcastle, UK with moderate to severe KCS, between March 2002 and June 2003. Relevant assessments such as dry eye history, clinical examination, dry eye diagnosis and dry eye management were performed at baseline. Patients were also asked to complete the Ocular Surface Disease Impact© (OSDI©) questionnaire and Dry Eye Disease Impact Questionnaire© (DEDIQ©), which included the Leisure Impact Index. Results: Sixty patients were included in the registry, of which 71.7% suffer from Sjögren’s Syndrome. Seventy–two percent of patients ranged from 50–80 years of age, with only 8% of patients younger than 40 years. Ninety–one percent was female. Patients reported that their most bothersome symptoms were dryness (22%), sensitivity to light (13%), and painful and sore eyes (13%). Eighty percent of patients experienced dry eye symptoms every day. Patients reported using artificial tears (AT) an average of 26.5 days in the last month (median 30 days, st.dev. 9.4) and instilled AT an average of 8.7 times per day over the last week (median 5.0 times, st.dev. 19.8). Patients had a dry eye severity level of moderate (58%) or severe (38%) based on physician evaluation and moderate (47%) or severe (43%) based on patient self–evaluation. The mean OSDI© score was 46.6 (median 44.5, st.dev. 21.7) which is considered clinically to be severe. The mean Leisure Impact Index (days in the last 3 months dry eye interfered with leisure activities) was 46.5 (median 40, st.dev. 37.8). Moderate correlations were observed between patient evaluation of their dry eye severity and imputed AT use, Leisure Impact Index, and OSDI score (r < 0.50, p<0.05). Conclusions: Using the OSDI© and DEDIQ© questionnaires, this study reveals that dry eye disease impacts quality of life of KCS patients almost daily. Overall, patients enrolled into the registry are older, female, and have signs and symptoms typical of dry eye disease. These patients are frequent users of artificial tears for their moderate to severe disease state. Patient’s evaluation of their symptom severity reflected the impact on their quality of life outcomes.
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