Abstract
Purpose :
To evaluate the practice patterns and opinion from international dry eye experts with respect to dry eye disease (DED) diagnosis in clinical practice.
Methods :
An online survey was distributed to DED experts all over the world. The use of diagnosis tests was evaluated in categories including: symptoms questionnaires, functional tests, tear film stability, tear volume, tear composition, ocular surface damage, ocular surface inflammation and eyelid assessment. After, the subjective importance of symptoms, tear break up time (TBUT), non-invasive TBUT, Schirmer test, tear meniscus height, osmolarity, metalloproteinase 9 (MMP9), blepharitis assessment and non-contact Meibography was evaluated according to Likert scale (never, rarely, sometime frequently and always).
Results :
The survey was sent to 110 experts, and 77 respondents completed the questionnaire (rate of response=70%). The majority of the experts were from North America (27%) and Europe (40%). Sixty-four participants (83%) had more than 15 years of clinical experience in managing DED. A majority of respondents (73%) diagnose DED using clinical signs and symptoms, but not fulfilling the DEWS II criteria. Seventy-six participants (98.7%) use symptoms questionnaires, being OSDI the most popular (83%), followed by DEQ-5 (30%). All participants evaluate damage to ocular surface, and fluorescein staining is the most frequent method used (92%). In addition, all the respondents perform meibomian gland and blepharitis assessment. Moreover, most of the respondents (78%, n= 60) use finger compression to evaluate meibomian gland function, and 84% utilize non-contact meibography. Furthermore, ocular surface inflammation, tear volume and tear film stability are evaluated by 82%, 98.7% and 96% of the experts, respectively. On the other hand, only 69.8% evaluate tear composition, being osmolarity the most common test (66.2%), and functional tests are performed by 70% of the respondents. With respect to the importance of different tests for DED diagnosis, TBUT (p= 0.002) and Schirmer’s (0.021) were found to be more important to experts from Europe than North America. No differences were found in any other test. (Fisher exact test p>0.05).
Conclusions :
This survey offers updated and day-to-day clinical practices by DED worldwide experts, including DED diagnosis. The results highlight the importance of symptoms and clinical signs, but not necessarily following a strict criteria.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.