Abstract
Purpose :
To validate a questionnaire to assess eye complaints that can detect the presence of anterior segment (AS) pathology and facilitate patient self-triage.
Methods :
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.
Results :
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).
Conclusions :
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.