June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Visual symptoms that differentiate patients with dry eye, cataract, glaucoma, and suspected glaucoma
Author Affiliations & Notes
  • David Zhao
    Glaucoma, Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Michael Quintero
    Glaucoma, Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Aleksandra Mihailovic
    Glaucoma, Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Pradeep Y Ramulu
    Glaucoma, Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   David Zhao None; Michael Quintero None; Aleksandra Mihailovic None; Pradeep Ramulu None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2810. doi:
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    • Get Citation

      David Zhao, Michael Quintero, Aleksandra Mihailovic, Pradeep Y Ramulu; Visual symptoms that differentiate patients with dry eye, cataract, glaucoma, and suspected glaucoma. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2810.

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

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Abstract

Purpose : Dry eye is a common condition frequently co-existing with other conditions such as cataracts and glaucoma. Here, we aim to ascertain visual symptoms that differentiate dry eye from cataract, glaucoma, or glaucoma suspect controls.

Methods : Adults with dry eye, glaucoma, cataract, and suspected glaucoma completed a questionnaire to rate the frequency and severity of 28 visual symptoms. Univariate logistic regression determined symptom frequency and severity differentiating dry eye from glaucoma, cataract, and glaucoma suspect patients. Subsequent multivariable logistic regression with backward stepwise selection determined the set of symptoms best distinguishing each disease pair.

Results : 353 patients (94 glaucoma suspects, 79 glaucoma, 84 cataract, and 96 dry eye) completed the questionnaire. Mean age was 64.1 years (SD=14.1); 66.6% of patients were female, and 68.3% white. Dry eye patients reported more frequent difficulty focusing (odds ratio (OR)=1.8, 95% confidence interval (CI)=1.2-2.7) and more severe light sensitivity (OR=3.2, 95% CI=2.1-4.8) compared to glaucoma suspects controls. These symptoms accounted for 30% of the variance in this comparison. Compared to glaucoma patients, those with dry eye reported more severe light sensitivity (OR=4.3, 95% CI=2.0-9.3) and increased blurred patches (OR=7.9, 95% CI=1.8-35.8), less difference in vision between both eyes (OR=0.2, 95% CI=0.1-0.5), poor peripheral vision (OR=0.06, 95% CI=0.01-0.3), wobbly vision (OR=0.2, 95% CI=0.05-0.8) and decreased frequency of missing patches of vision (OR=0.02, 95% CI=0.002-0.3). These six symptoms accounted for 61% of the variance in dry eye diagnosis compared to glaucoma. Compared to cataract patients, dry eye patients reported more frequent spots in vision (OR=1.9, 95% CI=1.2-3.0), glare (OR=1.8, 95% CI=1.2-2.9), light sensitivity (OR=2.2, 95% CI=1.5-3.2), more severe vision variability across the week (OR=2.8, 95% CI=1.5-5.5) and were less likely to report difference in vision between both eyes (OR=0.5, 95% CI=0.3-0.8) or vision getting worse (OR=0.3, 95% CI=0.2-0.5). These symptoms explained 37% of the variance in dry eye diagnosis compared to cataracts.

Conclusions : Different symptoms distinguish dry eye from cataract, glaucoma, and glaucoma suspect patients. Close attention to symptoms can improve patient communication and help guide treatment decisions.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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