Abstract
BackgroundInternational Task Force (ITF) guidelines established a grading scheme to support treatment of dry eye disease based on clinical signs and symptoms. The purpose of this study was to assess the impact of dry eye on vision-related function across ITF severity levels using the Ocular Surface Disease Index (OSDI) questionnaire.MethodsNon-interventional, cross-sectional study of prescription treatment-naïve dry eye patients seeking symptom relief at 10 ophthalmology and optometry practices. Clinicians assessed corneal and conjunctival staining, tear break-up time, Schirmer’s test (type I with anesthesia), and best-corrected visual acuity. Patients completed the OSDI questionnaire and OSDI overall and domain (Symptoms, Visual Function, and Environmental Triggers) scores were compared across ITF guidelines severity levels (1–4).ResultsOf 158 patients (mean age, 55 years) enrolled, 52 (33%) were ITF level 1, 54 (34%) ITF level 2, and 52 (33%) ITF levels 3/4 combined. No significant differences were observed in most baseline characteristics. Overall OSDI scores (mean [standard deviation]) were 26.5 [20.0] for ITF level 1, 33.8 [17.5] for ITF level 2, and 44.9 [26.1] for ITF level 3/4 cohorts (P < 0.0001). Component OSDI Symptoms, Visual Function, and Environmental Triggers domain scores all worsened with increasing ITF severity level (P ≤ 0.01).ConclusionsDry eye disease has significant deleterious impact on vision-related function across all ITF severity levels.
Highlights
International Task Force (ITF) guidelines established a grading scheme to support treatment of dry eye disease based on clinical signs and symptoms
Individual comparisons between ITF severity levels revealed differences in hypertension, diabetes and hyperlipidemia, which were significantly more frequent (P < 0.05) in the ITF level 3/4 cohort compared with ITF level 1 or ITF level 2 (Table 1)
Central corneal staining, which is indicative of more severe dry eye [29], was present in 56% of patients in ITF level 3/4 but no more than 2% of patients in either ITF level 1 or ITF level 2 (P < 0.0001 across all ITF levels)
Summary
International Task Force (ITF) guidelines established a grading scheme to support treatment of dry eye disease based on clinical signs and symptoms. The purpose of this study was to assess the impact of dry eye on vision-related function across ITF severity levels using the Ocular Surface Disease Index (OSDI) questionnaire. Dry eye is a multifactorial disease of the ocular surface resulting in discomfort, visual disturbance, and instability of the tear film [1]. In the early 2000s, it was estimated that dry eye affected over 7 million people over the age of 40 years in the United States [2, 3]. The symptoms that commonly compel patients with dry eye to seek treatment from ophthalmologists and optometrists include ocular discomfort and irritation, burning, itching, and blurred vision [7, 8]. Dry eye disease significantly affects patients’ visual function and greatly impacts social and physical functioning, workplace productivity, and quality of life [13, 14]. In one study conducted in the United Kingdom using utility assessment (Time Trade-Off and Standard Gamble methods) to quantify and understand the impact of a given health condition relative to other diseases, severe dry eye utilities were similar to those associated with dialysis or severe angina [19]
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