Dry Eye-Related Quality-of-Life Score Research Articles

Impact of tear metrics on the reliability of perimetry in patients with dry eye.

The application of artificial tears before performing perimetry can improve the reliability and results of perimetry in patients with glaucoma and dry eye (DE). However, the effects of ocular surface and tear film conditions on perimetry measurements and reliability have not been fully characterized. This prospective, cross-sectional, multicenter study investigated tear metrics in perimetry and assessed the relationships that existed among ocular surface condition, tear condition, and perimetry reliability. Forty-three eyes (43 patients) with DE disease according to the 2016 Japanese diagnostic criteria of DE and 43 eyes (43 subjects) of age- and visual field mean deviation-matched normal control subjects were studied. Perimetry was performed using the Humphrey Field Analyzer (30-2 SITA-Standard). Schirmer's test, strip meniscometry value, blink rate, tear film break-up time (TFBUT), fluorescein staining of ocular surface, and Dry Eye-related Quality of Life Score (DEQS) were measured. Blink rate was re-measured during perimetry. TFBUT and fluorescein staining were re-evaluated after perimetry. Perimetry reliability was evaluated with fixation loss, false-positive, and false-negative rates. Blink rate during perimetry was significantly lower for both patients with DE and normal controls (both P<0.001). TFBUT after perimetry was significantly higher than before perimetry in patients with DE (P<0.001). Fluorescein staining of ocular surface was significantly increased in patients with DE and normal control subjects (P = 0.002 and P<0.001, respectively). Spearman correlation analysis revealed that blink rate during perimetry was negatively correlated with fixation-loss rate (r = -0.393, P = 0.009) in patients with DE. Performing perimetry was associated with a significant change in tear condition and ocular surface condition in both patients with DE and normal control subjects. The changes in tear condition and ocular surface condition may impact the reliability of perimetry in patients with DE.

Analysis of the association between the severity of ocular and systemic pain

PurposeTo evaluate the relationship between the severity of ocular and systemic pain. MethodsA cross-sectional study was conducted in patients with ocular pain symptoms who were observed in Keio University Hospital between April 2017 and September 2018. Evaluations consisted of the Dry Eye-Related Quality of Life Score (DEQS), Short-Form McGill Pain Questionnaire (SF-MPQ), visual analog scale (VAS), and ophthalmologic examination, including tear breakup time measurement and Schirmer I test. The revised Asia Dry Eye Society Dry Eye Disease (DED) diagnostic criteria were used. ResultsThe present study involved 41 participants (31 women; mean age, 57.6 ± 17.5 years). Thirteen participants had aqueous-deficient DED, 18 participants had short tear break-up time DED, and 10 participants had no DED. Multivariate regression analysis revealed that the DEQS was significantly associated with both the SF-MPQ total (Coefficient score β = 0.92, p < 0.01) and the VAS (β = 0.25, p = 0.01). In addition, correlation analysis revealed that the DEQS had a significant positive linear correlation with both the SF-MPQ total (Spearman correlation score rs = 0.70, p < 0.01) and the VAS (rs = 0.66, p < 0.01). ConclusionsThe findings of the present study suggested that the ocular pain score was significantly associated with systemic pain score. Participants with higher systemic pain scores have an increased risk of having ocular pain.

Retrospective Observational Study on Rebamipide Ophthalmic Suspension on Quality of Life of Dry Eye Disease Patients.

Purpose The Dry Eye-Related Quality-of-Life Score (DEQS) is a Japanese dry eye-specific questionnaire that has been used to assess the symptoms of dry eye and their effects on the quality of life (QOL) in Japanese individuals. The purpose of this study was to determine the effect of rebamipide (RBM) on the QOL of Japanese patients with dry eye disease (DED). Method The medical records of 43 patients (3 men and 40 women; mean age: 64 ± 14 years; range: 32 to 83 years), who were diagnosed with DED and treated with RBM at the Ehime University Hospital between November 2012 and June 2016, were reviewed. The effects of 2% rebamipide (RBM) ophthalmic suspension on the symptoms of DED was determined by the answers to the DEQS questionnaire and clinical findings. The clinical findings before and 1, 3, 6, 12, and 24 months after initiating the RBM treatment were reviewed. The following data were collected from the DEQS: the Summary score and two subscale scores, the Bothersome ocular symptoms score, and the Impact on daily life score. In addition, the standard fluorescein staining score, the Schirmer I test score, and the tear breakup time (TBUT) score were analyzed. Result The Summary score and Impact of daily life score of the DEQS were improved significantly after 1, 3, 6, and 12 months of RBM, and the Bothersome ocular symptoms scores of the DEQS were also improved after 1, 3, and 6 months. The fluorescein staining scores were significantly decreased after 1, 3, 6, and 12 months, and the TBUT score was significantly increased after 1 month. Conclusion RBM treatment improves the QOL by alleviating the corneal and conjunctival epithelial damages. The DEQS is a useful questionnaire that can assess the severity of the DED symptoms and their impact on the QOL. This trial is registered with UMIN000024405.

Efficacy of Plate Expression of Meibum on Tear Function and Ocular Surface Findings in Meibomian Gland Disease.

To evaluate the clinical effectiveness of expression treatment on meibomian gland disease (MGD). Seventeen right eyes of 17 patients with MGD were divided into 3 groups in this randomized prospective clinical study: no expression group: routine treatment with no expression (five patients, five eyes); digital expression group: routine treatment with digital expression (five patients, five eyes); and plate expression group: routine treatment with plate expression (seven patients, seven eyes). All groups received the same routine treatment for 1 month. Tear film break-up time (TBUT), vital staining scores, meibum expressibility, and the dry eye-related quality of life score (DEQS) questionnaire results were assessed before and 1 month after treatment. There was a statistically significant difference of posttreatment TBUT among groups as determined by one-way analysis of variance (P<0.05). A post hoc test revealed that TBUT was statistically significantly higher in plate expression group compared with digital expression group. The fluorescein staining score did not show a statistically significant difference among the groups. Meibum expressibility and the DEQS scores improved in all groups. Plate expression when used as an adjunct to routine medical management of MGD has been found to be a comparatively effective treatment in terms of improvement of tear film stability compared with no expression or digital expression.

Patient-reported severity of dry eye and quality of life in diabetes.

PurposeThe purpose of the study was to assess the relationship between patient-reported severity of dry eye disease (DED), quality of life (QoL), presence of diabetic retinopathy (DR) and length of disease duration in people with type 1 diabetes mellitus (DM1) and type 2 diabetes mellitus (DM2).Patients and methodsA survey of 152 people (110 with and 42 without diabetes). All participants completed the Ocular Surface Disease Index (OSDI) and Dry Eye-related Quality of Life Score (DEQS) questionnaires.ResultsForty-four percent of all diabetic subjects reported dry eye symptoms, compared to 29% in the control group. Patients with DM2 reported dry eye symptoms more frequently than those with DM1 (55% and 27% respectively, P=0.001). Dry eye severity was linked to a significant deterioration in QoL in both types of diabetes (DM1, r=0.609 and P=0.036; DM2, r=0.417 and P=0.011). Irrespective of DR, the presence of DED was significantly higher in DM2 compared to DM1 (with DR, P=0.011; without DR, P=0.018).ConclusionDry eye symptoms are associated with reduced QoL and are more common in people with DM2 than in DM1, irrespective of DR status. Routine clinical screening for severe DED could potentially allow for a timely and more effective treatment and could contribute to mitigating the dry eye-associated reduction in QoL in those with DM2.

Factors influencing subjective symptoms in dry eye disease.

To retrospectively investigate the association between dry eye symptoms and clinical or in vivo confocal microscopy parameters in patients with dry eye disease (DED), and to compare these parameters between eyes with DED and normal subjects. This retrospective, cross-sectional, controlled study comprised 25 consecutive patients with non-Sjögren dry eye disease and age- and sex-matched 25 healthy subjects. Each patient underwent a complete examination of the ocular surface in the following order: tear osmolarity measurements, InflammaDry test, tear break-up time, corneal fluorescein staining, Schirmer I test, subjective symptoms questionnaire using the dry eye-related quality-of-life score (DEQS), and in vivo confocal microscopy analysis of the central cornea. Beck depression inventory (BDI) as depressive scale and history of medications and smoking were also evaluated. Stepwise multiple regression analysis was used to assess the factors affecting the DEQS. In univariate analysis, DEQS was associated with tear break-up time (ρ=-0.48, P=0.01), oral medications, such as hypotensive drug (ρ=0.56, P=0.004) and anti-depressant (ρ=0.57, P=0.003), and BDI (ρ=0.61, P=0.001) in patients with DED. In multiple regression analysis, explanatory variables relevant to the DEQS were the anti-depressant medications (P=0.04, partial regression coefficient B=21.04) and BDI (P=0.02, B=0.76, adjusted R 2=0.54) in these patients. Our study shows a significant association between depression and dry eye symptoms. It suggests that dry eye symptoms associate with higher depressive symptoms and its medications, although our patients were not followed longitudinally.

Epidermal Fatty Acid-Binding Protein: A Novel Marker in the Diagnosis of Dry Eye Disease in Sjögren Syndrome.

Purpose: Sjögren syndrome (SS) is a chronic inflammatory autoimmune disease of the lacrimal and salivary glands. This study compared the concentrations of epidermal fatty-acid binding protein (E-FABP) in the saliva, serum, and tears of SS patients with dry eye and dry mouth, with those of healthy adults to investigate the usefulness of E-FABP as a diagnostic marker for SS. Design: Prospective, observational case series. Participants: The subjects were 11 new patients with untreated Sjogren syndrome and 12 healthy control individuals. Methods: The diagnosis of SS was in accordance with the Ministry of Health, Labour and Welfare (Japan) Diagnostic Criteria (1999). Saliva, serum, and tear specimens were collected during internal medicine, dental, and ophthalmological examinations. The ophthalmological tests included the Dry Eye-related Quality of life Score (DEQS), tear break-up time (BUT), vital staining with fluorescein (FS) and lissamine green (LG), and the Schirmer test-1. The E-FABP concentration in the tears, saliva, and serum was measured by enzyme-linked immunosorbent assay (ELISA). Main outcome measure: The E-FABP concentrations were compared between patients and controls. Results: There were significant differences between the patient and healthy control groups in all ophthalmological test results. There were no significant differences between the groups in the E-FABP concentrations in the saliva (p = 0.1513) or the serum (p = 0.4799), but the E-FABP concentration in the tears significantly differed between groups. The E-FABP concentration in tears tended to be significantly lower in patients with SS (mean, 323.5 ± 325.6 pg/mL) than healthy control subjects (mean, 4076 pg/mL; p = 0.0136). The E-FABP concentration in tears significantly correlated with the results of dry eye parameters. Conclusion: The E-FABP concentration in tears appears to be related to ocular surface epithelial damage and tear stability and may be a promising novel biomarker in the diagnosis of SS.

The combination of strip meniscometry and dry eye-related quality-of-life score is useful for dry eye screening during health checkup: Cross-sectional study.

Strip meniscometry (SM) is a new method for quantification of tear volume using meniscometry strips inserted into the tear meniscus for 5 seconds. The dry eye (DE)-related quality-of-life score (DEQS) questionnaire comprises 15 questions regarding bothersome ocular symptoms and their impact on daily life. These 2 examinations require a relatively short time and are appropriate as screening tests. We evaluated the sensitivity and specificity of SM and DEQS for screening for DE syndrome during general health checkup.This study included 333 right eyes from 333 soldiers (331 men, 2 women; mean age, 42.8 ± 8.8 years) who underwent health checkups at the Yokosuka Medical Squadron between November and December 2013. We administered the DEQS questionnaire to the subjects. The fluorescein tear film break-up time and fluorescein and rose bengal staining scores were evaluated. A positive outcome was considered when DEQS >15 and SM scores <5 mm. We compared DEQS and SM between a DE group, suspected-DE group and normal group.Thirty-four (11%) soldiers were diagnosed with definite DE based on the Japanese DE diagnostic criteria. The sensitivities of SM, DEQS, and SM combined with DEQS for definite DE were 71%, 79%, and 59%, respectively, whereas the corresponding specificities were 85%, 91%, and 97%, respectively. None of the enrolled subjects experienced complications such as eye pain or discomfort, except for 1 soldier (0.003%) with conjunctivochalasis, who experienced irritation upon SM.The results of our study indicate that the combination of SM and DEQS is useful for the detection of DE with high sensitivity and specificity during routine health check-up.

Patients Preference of Diquafosol or Rebamipide Eye Drops for the Treatment of Mild Dry Eye: A Pilot Study

Purpose: To investigate the preference rates of recently developed eye drops, 3% diquafosol ophthalmic solution and 2% rebamipide ophthalmic suspension, as a randomized clinical trial in patients with dry eye.Methods: Eighteen patients (mean age: 59.7 years old, females: 77.8%) with reduced tear film break-up time (TBUT ? 5 sec) were enrolled in this study. They were treated with either diquafosol or rebamipide for 1 week, and treated for an additional week after switching to the other eye drop. This treatment was repeated one more time. Then, the patients were treated with one of either eye drop for an additional 4 weeks. Patients’ preferences for eye drops were investigated using a questionnaire at the end of 4-week treatment. To confirm the effectiveness of the treatments, objective and subjective assessments including superficial punctate keratopathy (SPK) score, TBUT measurement, and Dry Eye-Related Quality-of-Life Score (DEQS) were performed at baseline, and 4 and 8 weeks.Results: SPK score was improved after treatment (P &lt; 0.05). Patients tended to prefer diquafosol (64.7%) torebamipide (35.4%), however there was no significant difference in two eye drops (P = 0.23). Bitterness was reported significantly more frequently after rebamipide administration (66.7%) than diquafosol administration (5.6%, P &lt; 0.001). The diquafosol bottle was considered “ease to use” by a larger percentage of users (94.1%) as compared to the rebamipide bottle (58.8%, P &lt; 0.05). The effectiveness of the signs and symptoms were similar for both groups at 8 weeks.Conclusions: Diquafosol and Rebamipide were both effective in treating dry eye and 65% of the patients choose Diquafosol. Bitterness after administration and ease to use of the bottles seemed to affect the patients’ preferences for these two eye drops.

A Prospective, Randomized Trial of Two Mucin Secretogogues for the Treatment of Dry Eye Syndrome in Office Workers

The purpose of the study was to compare the two mucin secretogogues, diquafosol (DQS) and rebamipide (RBM), for the treatment of dry eye syndrome (DES) in office workers. Dry eye patients using computers for >4 h/day were randomly assigned treatment with either DQS or RBM. Main outcomes measures included changes in tear film break-up time (TBUT) and subjective symptoms assessed by the Dry Eye-Related Quality of Life Score (DEQS). The subjects had scheduled examinations at 0 and 4 weeks, and the examinations at 2 and 8 weeks were optional. Changes in keratoconjunctival fluorescein score and a patient satisfaction questionnaire were also recorded. Both groups showed significant improvements in the DEQS scores at 2, 4, and 8 weeks following the initiation of the study. Both groups showed significant increases in the TBUT at 2 and 4 weeks. No significant difference was found between the DQS and RBM groups at any time periods. Patients reported more comfort with the use of DQS compared with the use of RBM. No local or systemic side effects were noted. The results of the present study indicated that both DQS and RBM were effective for the treatment of DES in office workers.

Effect of topical 3% diquafosol sodium on eyes with dry eye disease and meibomian gland dysfunction.

PurposeTo prospectively evaluate the effect of topical diquafosol sodium on eyes with dry eye disease (DED) and meibomian gland dysfunction (MGD).Patients and methodsThe subjects were consecutive patients diagnosed with both DED and MGD at Inouye Eye Hospital between March and September of 2016. The subjects were administered topical 3% diquafosol sodium ophthalmic solution six times a day for 3 months. At each study visit, subjects underwent slit-lamp examination and completed MGD symptoms and dry eye-related quality of life score (DEQS) questionnaires. Meibum quality (meibum score) and meibomian gland loss (meiboscore) were evaluated. Tear lipid layer thickness was measured in both eyes with an ocular surface interferometer immediately after clinic arrival and 20 minutes after instillation of one drop of topical diquafosol.ResultsThirteen patients (3 men, 10 women) with a mean age of 69.5±8.3 years completed the 3-month study. The number of telangiectasia and plugged meibomian gland orifices significantly decreased from baseline after 1 month of diquafosol use. The meibum score and the meiboscore significantly decreased from baseline at 3 months. Also, the lipid layer thickness was greater after diquafosol administration than before administration at baseline and 1, 2, and 3 months by 12.2, 11.5, 9.5, and 17.0 nm, respectively, but this difference was only significant at 3 months (p=0.039). The DEQS ocular symptom (p=0.065) and MGD questionnaire (p=0.081) scores tended to be lower than baseline at 3 months.ConclusionDiquafosol sodium ophthalmic solution improves DED- and MGD-related signs in eyes with MGD.

Effects of Diquafosol Ophthalmic Solution on Quality of Life in Dry Eye Assessed Using the Dry Eye-Related Quality-of-Life Score Questionnaire: Effectiveness in Patients While Reading and Using Visual Display Terminals.

Diquafosol ophthalmic solution improves objective findings in the ocular surface and subjective symptoms in patients with dry eye. The Dry Eye-Related Quality-of-Life Score (DEQS) questionnaire was developed to assess dry eye symptoms and their effects on quality of life. However, because little research using the DEQS has been reported, we evaluated the effects of diquafosol ophthalmic solution on ocular surface findings and quality of life using the DEQS in patients with dry eye. Sixty-three patients with dry eye were assigned to the control group (artificial tears) or diquafosol group. Both groups instilled 1 drop of the solution in both eyes 6 times daily and were evaluated after 2 weeks; the diquafosol group also was instructed to be examined at 1 and 3 months. We evaluated the subjective symptoms using the DEQS, fluorescein staining score, tear film breakup time (BUT), Schirmer testing, and lower tear meniscus height with anterior-segment optical coherence tomography. In the diquafosol group, the fluorescein staining score, BUT, tear meniscus height, and DEQS scores improved significantly compared with before treatment in contrast to the control group. Furthermore, in the diquafosol group, the staining score and BUT improved significantly compared with the control group. Analysis of each DEQS item indicated that diquafosol ophthalmic solution relieved foreign body sensation and problems when reading and using visual display terminals compared with the control group. Diquafosol ophthalmic solution was effective in patients with dry eye, especially those with foreign body sensation and problems when reading and using visual display terminals.

Symptoms of Dry Eye Disease and Personality Traits.

The essential targets of dry eye disease (DED) treatments include both objective signs and subjective symptoms. However, due to the numerous subjective symptoms, it is understandable why little association has been found between the signs and symptoms. Although psychological influences on the subjective symptoms have been reported, little is known about the influence of personality traits. The present study analyzed the relationship between the signs/symptoms of DED and the personality traits of patients using a cross-sectional design. We examined 56 DED patients (mean age; 62.4 ± 12.9, range 34–85 years) visiting the outpatient clinic of the Department of Ophthalmology at the Nippon Medical School Hospital in Tokyo, Japan. Objective signs evaluated included the Schirmer I test, tear breakup time (BUT), fluorescein and lissamine green staining, and tear osmolality. Subjective symptoms were assessed by the Ocular Surface Disease Index (OSDI) and Dry Eye-Related Quality-of-Life Score (DEQS) questionnaires. For personality traits, the Big Five personality traits model analysis was used. Correlations between the objective signs, subjective symptoms, and personality traits were analyzed. A significant correlation was found between the neuroticism in the Big Five Personality Inventory and the symptoms assessed by the DEQS (r = -0.35, p < 0.01), and the OSDI (r = -0.28, p < 0.05). There was no significant correlation observed between the signs and the symptoms, or between the signs and any personality traits. The results of our current study suggest that the personality of the patient, which appears to be the basis of various psychological factors, can have some impact on the subjective symptoms. This may be one of the reasons why there has been little association noted between the signs and symptoms of DED.

Changes in ocular higher-order aberrations following botulinum toxin treatment in patients with blepharospasm : BTX improves dry eye in patients with BEB.

To evaluate the effects of botulinum toxin type A (BTX-A) treatment in patients with benign essential blepharospasm (BEB) by monitoring the ocular surface and ocular higher-order aberrations (HOAs) before and after treatment. The present study reports a prospective case series of 38 patients (76 eyes, 11 men and 27 women; mean age 66.8±9.8years) with BEB who underwent BTX-A treatment at Kokura Memorial Hospital between 2013 and 2014. Patients were evaluated for ophthalmoscopic findings, Schirmer I test, tear film break-up time (t-BUT), HOAs, fluctuation index (FI), stability index (SI) using a wavefront aberrometer, 15 subjective symptoms using the Dry Eye-Related Quality of Life Score (DEQS), and complications before and after the treatment. After BTX-A treatment, the Schirmer I test score improved significantly from 5.9±5.4 to 8.7±6.1mm and t-BUT recovered from 5.2±1.7 to 7.3±1.7s. HOAs were classified into four patterns: stable (60.5%), small fluctuation (14.5%), sawtooth (17.1%), and reverse sawtooth (7.9%), and they significantly reduced after the treatment. Only FI (not SI) showed a marked reduction, and the DEQS significantly improved from 44.7±21.6 to 37.6±21.0 after the treatment (p<0.05). There were no complications during the observations. BTX-A is a treatment with a high potential to improve ocular surface disorders induced by BEB.

Diquafosol for Soft Contact Lens Dryness: Clinical Evaluation and Tear Analysis.

To evaluate the efficacy of topical application of 3% diquafosol tetrasodium solution for the treatment of soft contact lens (SCL) wearers with dryness. In addition to clinical tests and subjective symptoms, we assessed the fluorescence intensity of wheat germ agglutinin conjugate of fluorescein (F-WGA) used as a marker of membrane-associated mucins and sialic acid concentration in tear fluids as a marker of secreted mucins. Twelve SCL wearers with dryness symptoms were treated with diquafosol for 4 weeks. Clinical tests included the tear film break-up time (BUT), corneal and conjunctival fluorescein staining scores, and Schirmer values. Subjective symptoms were evaluated by the Dry Eye-Related Quality-of-Life Score (DEQS). Fluorescence intensities in the central cornea were measured by fluorophotometry at 5 minutes after a 5% F-WGA solution was applied to the eye. The tears collected by the Schirmer test strips were analyzed by high-performance liquid chromatography (HPLC), and the concentrations of sialic acid; total protein; and the four major tear proteins secretory IgA, lactoferrin, lipocalin-1, and lysozyme proteins were measured. Comparing the results before and after diquafosol treatment, BUT (p < 0.01), kerato-conjunctival staining score (p < 0.05), corneal staining score (p < 0.05), and DEQS score (p < 0.01) showed statistically significant improvements. The F-WGA fluorescence intensities (p < 0.0001) significantly increased after treatment, whereas the concentrations of sialic acid and tear proteins remained unchanged. Topical application of diquafosol solution to the SCL wearers with dryness improved biomarker of membrane-associated mucins, BUT, staining of cornea and conjunctiva, and subjective symptoms.

Diquafosol sodium ophthalmic solution for the treatment of dry eye in soft contact lens wearers

AbstractPurpose Ocular dryness, experienced by up to 75% of soft contact lens (SCL) wearers, is the main reason for its discontinuation. The aim of the study is to evaluate the efficacy of topical application of diquafosol sodium for the treatment of dry eye in SCL wearers. In addition to clinical tests, we used a wheat germ agglutinin conjugate of fluorescein (F‐WGA) and fluorophotometry to evaluate the glycocalyx in the ocular surface in vivo.Methods Twelve SCL wearers with dry eye symptoms (31.3 ± 6.8 year‐old) were treated with 3% diquafosol eyedrops for 4 weeks. The clinical tests included tear break‐up time (BUT), Schirmer test, fluorescein staining score, and subjective symptoms evaluated by the Dry Eye Related Quality of Life Score (DEQS). Five minutes after a 5% F‐WGA solution was applied to the eye, fluorescent intensities in the central cornea were measured by fluorophotometry.Results When comparing before and after diquafosol treatment for 4 weeks, BUT (3.6±2.2 sec to 5.0±2.1 sec, p=0.003), kerato‐conjunctival staining score (2.8±1.8 to 2.1±1.4, p=0.045) and DEQS score (19.2±12.7 to 10.6±12.5, p=0.0032) showed statistically significant improvements (Wilcoxon signed‐rank test). F‐WGA fluorescent intensities in the central cornea (571.8±227.8 to 794.6±219.4, p&lt;0.0001) significantly increased, and had a significant correlation with BUT.Conclusion Fluorophotometric measurement of WGA staining appears to reflect the glycocalyx in the corneal epithelium, and therefore can be a good indicator of the ocular surface wettability. Topical application of diquafosol sodium improved subjective symptoms of SCL wearers with dry eye, possibly by enhancing tear film stability and reducing damage of ocular surface epithelia.

Development and Validation of the Dry Eye–Related Quality-of-Life Score Questionnaire

A validated questionnaire that assesses symptoms and the effect of dry eye disease (DED) on the patient's daily life is needed to evaluate the condition. To develop and validate the Dry Eye-Related Quality-of-Life Score (DEQS) questionnaire in Japan. Development and evaluation of the DEQS questionnaire were conducted in 4 phases: (1) item generation, (2) pilot study to assess content and face validity, (3) preliminary psychometric validation study to examine factor structure and reduce the number of items, and (4) final psychometric validation with 224 participants (203 with DED and 21 serving as controls). Participants completed the DEQS questionnaire, the Short Form-8, and the National Eye Institute Visual Function Questionnaire-25. To evaluate reproducibility and responsiveness, individuals with DED completed the DEQS questionnaire twice. Internal consistency, reproducibility, discriminant validity, concurrent validity, and responsiveness. Items were generated from a literature review, and 35 items were selected for the draft version. In the pilot study, 11 items were deleted; furthermore, 9 items were deleted based on the results of item analysis and factor analysis in the preliminary validation study. The final 15-item DEQS questionnaire consisted of an Overall Summary scale and 2 multi-item subscales: Impact on Daily Life and Bothersome Ocular Symptoms. The psychometric analysis revealed that the DEQS questionnaire has good internal consistency, test-retest reliability, discriminant validity, and responsiveness to change. The DEQS questionnaire correlated well with the mental component of the Short Form-8 and showed strong correlations with 4 subscales (Ocular Pain, Near Vision, Distance Vision, and Mental Health) of the National Eye Institute Visual Function Questionnaire-25. The DEQS questionnaire is valid and reliable for evaluating the multifaceted effect of DED on the patient's daily life, including mental health, and it can be used easily in routine clinical practice.