Comparison of Clinical Use of Ocular-surface Disease Index Questionnaire, Tear Film Break-up time, and Schirmer Tests in Diagnosing Dry-eye

Abstract

Aims: To evaluate and compare the diagnostic values and clinical utility of the Ocular Surface Disease Index (OSDI) questionnaire, the tear film break-up time test (TBUT), and the Schirmer’s test in diagnosing dry eye disease in patients presenting with dry eye symptoms.
 Study Design: A prospective observational study.
 Place and Duration of Study: Department of Ophthalmology, AIIMS Jodhpur, Rajasthan, India. Two-month period between July 2016 and September 2016.
 Methodology: We have included 100 patients aged >20 years having foreign body sensations, burning sensations, pain, dryness, blurred vision, photophobia, redness in the study. Routine ophthalmological examination was performed after OSDI questionnaire, followed by TBUT and Schirmer’s test and outcomes were evaluated.
 Results: The mean age of 100 participants was 43 ± 15.97years (range 20–78 years). The mean OSDI, TBUT, and Schirmer’s test scores were 58.67± 12.12 (range 30.0–88.9), 5.77 ± 3.49 seconds (range 0–17 seconds), and 09.78 ± 7.93 mm (range 0–32.5 mm), respectively. There was a statistically highly significant inverse correlation between the OSDI and TBUT (r = −0.597, P = <0.0001), statistically significant correlation between TBUT and Schirmer test (r= -0.227, p= 0.023), whereas no significant correlation noted between the OSDI and Schirmer’s test (r= -0.142, p= 0.158). 
 Conclusion: The prevalence of dry eye disease (DED) is increasing these days. For early recognition and treatment, we need rapid, reliable and less invasive diagnostic test in daily practice. The OSDI together with the TBUT is less time consuming, easy to perform and can be useful in diagnosis of DED.