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C.G. Begley, R.L. Chalmers, L. Abetz, K. Venkataraman, P. Mertzanis; Relationship Between Symptom Profile and Clinical Signs Among Dry Eye Patients . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2473.
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Purpose: The purpose of this study was to investigate symptoms and clinical signs among dry eye and normal subjects in a cross-sectional multi-center clinical study. Methods: Subjects (122) aged 35 to 65 were recruited by dry eye diagnostic codes and a telephone interview including 28 control subjects (C), 73 with non-Sjogren’s keratoconjunctivis sicca (non-SS KCS) and 21 with Sjogren’s Syndrome (SS). Subjects completed the Dry Eye Questionnaire 2001 (DEQ 2001) and 5 other questionnaires, followed by dry eye clinical tests. Results: The most frequently reported symptoms among dry eye subjects were discomfort and dryness; many symptoms increased in intensity over the day and were quite bothersome. Groups showed a significant difference in corneal fluorescein staining, conjunctival lissamine green staining, the Schirmer 1 tear test, and tear break-up time (Chi-square and Kruskal Wallis, p<0.0001). Statistically significant, but moderate, correlations occurred between the frequency and evening intensity of some symptoms and Schirmer’s tear test, overall corneal fluorescein staining, and temporal lissamine green conjunctival staining (Spearman’s; r=0.31 to 0.45, p<0.01). Symptoms were moderately to highly correlated with the clinician’s grade of dry eye and the self assessment of dry eye severity (r=0.46 to 0.86, p<0.0001). Signs were moderately correlated to the clinician grade (r= 0.26 to 0.48) but showed low correlation to the self-assessment of severity (r=0.22 to 0.35, p=<0.01). Conclusions: Dry eye subjects reported frequent and intense evening levels of many ocular surface symptoms, some of which were moderately correlated with clinical tests. The clinician grading of dry eye was more highly correlated with patient symptoms than clinical signs, suggesting that clinician grades are influenced by both patient symptoms and clinical test results.
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