July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Determinants of Ocular Discomfort Severity Among Participants in the Dry Eye Assessment and Management (DREAM) Study
Author Affiliations & Notes
  • Rony R Sayegh
    Ophthalmology, Case Western Reserve University, Cleveland, Ohio, United States
    Ophthalmology, Cleveland Clinic Abu Dhabi, Abu Dhabi, Abu Dhabi, United Arab Emirates
  • Maureen G Maguire
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Yinxi Yu
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • John Farrar
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Roni M Shtein
    Ophthalmology, University of Michigan, Ann Arbor, Michigan, United States
  • Eric Kuklinski
    Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Penny A Asbell
    Ophthalmology, University of Tennessee Health Science Center, Tennessee, Tennessee, United States
  • Footnotes
    Commercial Relationships   Rony Sayegh, None; Maureen Maguire, Genentech-Roche (C); Yinxi Yu, None; John Farrar, None; Roni Shtein, None; Eric Kuklinski, None; Penny Asbell, Alcon (C), Alcon (R), CLAO (C), Dompe (C), Kala (C), MC2 (F), Medscape (C), Miotech (R), Novaliq (C), Santen (C), Santen (R), Shire (C), Sun Pharma (C)
  • Footnotes
    Support  Supported by cooperative agreements U10 EY022879, U10 EY022881 from the National Eye Institute and supplemental funds from the Office of Dietary Supplements, National Institutes of Health, Department of Health and Human Services.
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6747. doi:
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      Rony R Sayegh, Maureen G Maguire, Yinxi Yu, John Farrar, Roni M Shtein, Eric Kuklinski, Penny A Asbell; Determinants of Ocular Discomfort Severity Among Participants in the Dry Eye Assessment and Management (DREAM) Study. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6747.

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      © ARVO (1962-2015); The Authors (2016-present)

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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.


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