Epidemiology of discordance between symptoms and signs of dry eye

2017 ◽  
Vol 102 (5) ◽  
pp. 674-679 ◽  
Author(s):  
Erin S Ong ◽  
Elizabeth R Felix ◽  
Roy C Levitt ◽  
William J Feuer ◽  
Constantine D Sarantopoulos ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
The Body ◽  
Psychological Status ◽  
Ocular Surface Disease ◽  
Post Traumatic Stress ◽  
Ocular Pain ◽  
Ocular Surface Disease Index ◽  
System Integrity ◽  
Symptoms And Signs

Background/aimsThe frequent lack of association between dry eye (DE) symptoms and signs leads to challenges in diagnosing and assessing the disease.MethodsParticipants underwent ocular surface examinations to evaluate signs of disease and completed questionnaires to assess ocular symptoms, psychological status and medication use. To assess nociceptive system integrity, quantitative sensory testing (QST), including vibratory and thermal threshold measures and temporal summation of pain were obtained at the forearm and forehead. Correlations between DE discordance score (degree of discrepancy between symptom severity and DE signs) and patient characteristics were determined. Higher discordance scores indicated more symptoms than signs.Results326 patients participated (mean age: 62 years; SD: 10 years; 92% men). Age was negatively correlated with DE discordance score (Pearson r=−0.30, p<0.0005), while mental health indices were positively correlated. Chronic pain elsewhere in the body (ie, non-ocular pain conditions) and intensity ratings of prolonged aftersensations of pain evoked by noxious hot and cold stimuli were also significantly correlated with DE discordance score. Multiple linear regression demonstrated that post-traumatic stress disorder and non-ocular pain intensity were important predictors of DE discordance score, Dry Eye Questionnaire-5 and Ocular Surface Disease Index and that DE discordance was also sensitive to QST as well.ConclusionsThe present study provides evidence that the degree of discordance between DE symptom report and measurable signs of ocular surface disease is associated with comorbidities related to clinical pain and to hyperalgesia as demonstrated with QST. Understanding the epidemiology of DE discordance can aid in interpreting the DE exam and individualising treatment.

The Effect of Low-Dose Aspirin on Dry Eye Parameters and Ocular Surface Disease Index Questionnaire

2018 ◽  
Vol 34 (3) ◽  
pp. 256-259 ◽  
Author(s):  
Alper Yazıcı ◽  
Esin Sarı ◽  
Erkan Ayhan ◽  
Gözde Şahin ◽  
Nesime Setge Tıskaoğlu ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Low Dose ◽  
Disease Index ◽  
Ocular Surface Disease ◽  
Ocular Surface Disease Index ◽  
Dose Aspirin ◽  
Low Dose Aspirin

Individuals with migraine have a different dry eye symptom profile than individuals without migraine

2019 ◽  
Vol 104 (2) ◽  
pp. 260-264 ◽  
Author(s):  
Monika Farhangi ◽  
Ryan J Diel ◽  
Dawn C Buse ◽  
Amy Michelle Huang ◽  
Roy C Levitt ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Cross Sectional Study ◽  
Ocular Surface Disease Index ◽  
Cross Sectional ◽  
Symptom Profile ◽  
Nerve Dysfunction ◽  
The Difference ◽  
Symptoms And Signs

BackgroundMany individuals with migraine report symptoms of dry eye (DE). However, it is not known whether DE profiles are similar between individuals with and without migraine. To bridge this gap, we evaluated symptoms and signs of DE, including symptoms suggestive of nerve dysfunction, in a large group of individuals with DE symptoms, and compared profiles between individuals with migraine and those without migraine or headache.MethodsProspective cross-sectional study of individuals with DE symptoms seen at the Miami VA.ResultsOf 250 individuals, 31 met International Classification of Headache Disorders criteria for migraine based on a validated screen. Individuals with migraine were significantly younger (57 vs 62 years) and more likely to be female (26% vs 6%) than controls. Individuals with migraine had more severe DE symptoms and ocular pain compared with controls (mean Ocular Surface Disease Index 53.93 ± 21.76 vs 36.30 ± 22.90, p=0.0001; mean Neuropathic Pain Symptom Inventory modified for the Eye 39.39 ± 23.33 vs 21.86 ± 20.17, p=0.0001). The difference in symptom profile occurred despite similar ocular surface parameters between the groups.ConclusionsIndividuals with migraine had a different DE symptom yet a similar DE sign profile when compared with controls without migraine. This suggests that DE symptoms in individuals with migraine may be driven by nerve dysfunction as opposed to ocular surface abnormalities.

scholarly journals A Comparison of Symptoms and Signs in Patients with Inflammatory Dry Eye Disease using two Commercially Available Treatment Formulations of Cyclosporine A

2021 ◽  
Author(s):  
Jonatan Olafsson ◽  
Snorri Olafsson ◽  
Hugo Lewi Hammer ◽  
Behzod Tashbayev ◽  
Øygunn A. Utheim ◽  
...  
Keyword(s):  
Dry Eye ◽  
Cyclosporine A ◽  
Ocular Surface ◽  
Ocular Surface Disease Index ◽  
Treatment Groups ◽  
Surface Staining ◽  
Work Up ◽  
Symptoms And Signs ◽  
Significant Superiority ◽  
Ocular Surface Inflammation

Abstract Purpose: Dry eye (DED) is a multifactorial disease of the ocular surface in which ocular surface inflammation and damage play etiological roles. In the present study, we compared symptoms and signs in patients with DED treated with 0.1% Cyclosporine A (CsA) cationic emulsion (Ikervis, Santen) and 0.05% CsA anionic emulsion (Restasis, Allergan).Methods: Single-center, retrospective, 202 consecutive DED patients were treated with 0.1% CsA cationic emulsion (Ikervis, n=101) or 0.05% CsA anionic emulsion (Restasis, n=101) over six months. Ophthalmological work-up included Ocular Surface Disease Index (OSDI) questionnaire, fluorescein break-up time (FBUT), fluorescein ocular surface staining (OSS), Schirmer’s test, meibum expressibility (ME), and meibum quality (MQ). Results: In both treatment groups, subgroup analysis revealed a significant improvement of OSDI only in patients with severe symptoms at baseline (OSDI 33-100). Ikervis-treated patients with OSDI <23 at baseline had a significant increase in symptoms. OSS and FBUT improved significantly in most subgroups irrespective of Ikervis or Restasis being used. Regression analysis revealed a significant superiority to Restasis with regard to FBUT improvement and superiority to Ikervis in regards ME improvement. Conclusions: We conclude that there is seemingly no substantial difference in efficacy between the two drugs. The strength of Restasis is increased efficacy at improving FBUT and of Ikervis improving ME.

scholarly journals Topical Cyclosporine in Treatment of Post-LASIK Symptomatic Dry Eye

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Muhammad Saeed Iqbal ◽  
Kanwal Latif
Keyword(s):  
Dry Eye ◽  
Cyclosporine A ◽  
Ocular Surface ◽  
Case Series ◽  
Tear Film ◽  
Disease Index ◽  
Ocular Surface Disease ◽  
P Value ◽  
Statistical Interpretation ◽  
Ocular Surface Disease Index

Purpose:  To determine the role of 0.05% topical cyclosporine A (CsA) in treatment of symptomatic dry eye after LASIK (Laser-Assisted in Situ Keratomileusis). Study Design:  Interventional Case Series. Place and Duration of Study:  Ophthalmology Department, Sir Syed Hospital, Karachi, from July 2018 to Dec. 2019. Methods:  Seventy-five patients who underwent LASIK for myopic refractive error and presented with symptomatic dry eye and showed no response to artificial tears therapy after 1 month of LASIK were selected. The patient had ablation zone diameter of 6mm and flap diameter was 8.5mm to 9mm. Cyclisporine A 0.05% ophthalmic preparation was added to treatment regimen and response was observed at 1, 3 and 6 months. OSDI (Ocular Surface Disease Index) scores, Tear film break up time (TBUT), Schirmer's test (ST) values and Best Corrected Visual Acuity (BCVA) were recorded to analyze the treatment response at each visit. The statistical interpretation was done by using SPSS version 21. To interpret the correlation between pre-treatment and 6 month post treatment, Paired sample T test was applied with 95% Confidence Interval; CI and p-value of ≤ 0.05. Results:  The mean post-LASIK OSDI score of enrolled patients was 54.25 ± 10.81. After 6 months of treatment mean OSDI score was improved to 21.05 ± 5.13 (p < 0.001). Post-LASIK mean ST value was 5.2 ± 1.2 mm and mean TBUT value was 5.6 ± 1.3 seconds, which changed to 9.8 ± 1.0 mm and 8.9 ± 1.1 seconds respectively. BCVA improved from Log MAR 0.14 ± 0.09 to 0.01 ± 0.03 (p < 0.001). Conclusion:  Topical CsA 0.05% was effective in alleviating the symptoms of post-LASIK dry eye. Key Words:  LASIK, Dry eye, Ocular Surface Disease Index Score, Cyclosporine A.

Sign in / Sign up

Export Citation Format

Share Document