Abstract
Purpose :
To report ocular discomfort severity among patients with moderate to severe dry eye disease (DED) and evaluate factors associated with them.
Methods :
Participants (N=535) in the DREAM Study, all with both signs and symptoms of DED, rated the average severity over the past week of their ocular discomfort on an 11-point scale (0-10) as part of the BODI questionnaire, completed the OSDI on symptoms and SF-36 on quality of life, and had a comprehensive ophthalmic assessment by a study-certified clinician. A dry eye discordance score was calculated using the OSDI score and results from Schirmer test and measurements of tear breakup time, corneal and conjunctival staining, and meibomian gland dysfunction. Regression analysis was used to determine the factors associated with ocular discomfort severity and with symptom and sign discordance.
Results :
Subjects with severe ocular discomfort (score 7-10, n=60) had significantly worse scores for OSDI, general health perception, bodily discomfort, social functioning, general activity level, mood, walking ability, ability for normal work, and sleep, compared to those with mild discomfort (score 0-2, n=110). They also had higher mean corneal staining and Schimer scores which were statistically but not clinically significant. Subjects with high discordance scores (more symptoms than signs) were younger, had a higher discomfort score, and experienced less relief from treatment. Neither discomfort nor discordance scores correlated with fibromyalgia, depression, or antidepressant medication use.
Conclusions :
A large number of DREAM participants reported ocular discomfort. Those with severe discomfort had a higher level of discordance between signs and symptoms of dry eye. Ocular discomfort significantly impacts dry eye patients’ lives and social functioning. Younger age was correlated with increased discordance between eye symptoms and signs.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.