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JJ Nichols, KK Nichols, G Mitchell; Is There An Association Between Signs and Symptoms in Patients with Dry Eye? . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3887.
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Purpose:The association between signs and symptoms in patients with dry eye is controversial. The purpose of this research was to examine the frequency of and relations between various dry eye symptoms and dry eye test results in patients with dry eye. Methods:Seventy-five patients (70.7% female, median age 46.2 years, range 21.4 to 81.0 years) with a previous dry eye diagnosis (ICD-9 375.15, dry eye syndrome) were recruited for participation in this study. Patients were interviewed regarding the frequency of various dry eye symptoms including dryness, grittiness, soreness, redness, and ocular fatigue. A dry eye examination was then conducted including the Schirmer Test, fluorescein tear break-up time (TBUT), corneal and conjunctival staining with fluorescein and rose bengal. Statistical analyses reflected various scoring mechanisms for both signs and symptoms including categorical, continuous, and ordinally-scaled items. Results:The most common symptom reported was dryness (98.7%), followed by ocular fatigue (85.1%), grittiness (78.4%), redness (71.6%), and soreness (64.5%). The average Schirmer test was 16.9 ± 14.2 mm, the average TBUT was 5.7 ± 3.4 seconds, the average corneal staining score was 1.0 ± 1.5 using fluorescein, and the average conjunctival staining score was 1.0 ± 1.9 using rose bengal. There were no significant correlations between any individual symptoms and signs of dry eye in this sample of dry eye patients. Additionally, there were no associations between patients reporting any three symptoms at least frequently (moderate-to-severe dry eye symptoms) and any dry eye test results including the Schirmer test, TBUT, and staining with fluorescein and rose bengal. Conclusion:This study suggests a poor relation between signs and symptoms in dry eye patients. The development of dry eye tests, sensitive to symptoms of dry eye, is needed to help clinicians in the diagnosis of this disease.
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