Dry Eye Disease Patient Surveys

Utilizing a patient intake form has become standard in many of our practices; asking for patients’ medical health history, ocular health history, family history as well as daily use of medications. The addition of an eye comfort survey to our intake forms can uncover dry eye disease for a number of our patients.  

There are many varieties of eye comfort surveys – customized version as well as validated surveys and in some cases, it can be helpful to employ the use of a few different ones.

Commonly Used Patient Surveys

DEQ 5

5 questions scored 0-5 validated to aid in the differentiation between dry eye patients and normal patients. Developed by Dr. Chalmers, Begley and Caffery this questionnaire also helps differential patients with and without Sjögren’s syndrome.  

Results scoring >6 suggest dry eye disease and  >12 require further testing to rule out Sjögren’s syndrome.(1)

The OSDI, developed by Allergan (Allergan Inc, Irvine, CA)(2) consists of 12 questions to evaluate the frequency of symptoms over the past week, including questions on ocular symptoms, visual function, and environmental triggers.  

Each question is scored by the patient from 0-4 with the total score ranging from 0 to 100. A severity of normal, mild moderate and severe are given based on the total score.  

With the OSDI app the calculation which was a bit labor intensive is fast and accurate.  

Standard Patient Evaluation of Eye Dryness (SPEED)

A validated dry eye survey that like its name is fast which helps with patient (and staff) compliance. Using eight questions the SPEED survey evaluates the frequency and severity of symptoms.   

The severity of symptoms is subjective and scored 0-4 with zero being no symptoms. The numeric value for each of the eight questions is added with scores ranging from 0-28. 

The symptoms Korb and Blackie used for this survey help to quickly identify possible underlying causes. Grittiness is common complaint of patients with lid wiper epitheliopathy, while burning is often found in patients with partial blinks.(3)

Symptom Assessment in Dry Eye SANDE

The SANDE questionnaire is only 2 questions: (1) How often do your eyes feel dry and/or irritated? and (2) How severe do you feel your symptoms of dryness and/or irritation are?

Scoring the SAME questionnaire is done by multiplying the frequency score by the severity score and obtaining the square root.(4)

UNC  Dry Eye Management Scale (DEM)   

Dr. Richard Davis of the University of North Carolina developed the UNC as a single-item questionnaire that accesses dry eye symptoms and their effect on quality of life.  

There is growing data showing the quality of life effects dry eye disease has on our patients.

In summary…

Eye Comfort questionnaires allow us to identify dry eye symptoms prior to the patient exam allowing the doctor to focus efforts actively looking for clinical symptoms of dry eye disease.

In addition to providing a measure in which we can determine if treatment is providing symptom relief. These surveys also help narrow the type of dry eye as well as identify when further testing is needed.

References:

  1. Chalmers RL, Begley CG, and Caffery B, Validation of the 5-Item Dry Eye Questionnaire )DEQ-5): Discrimination across self-assessed severity and aqueous tear deficient dry eye diagnosis.  Contact Lens & Anterior Eye 33 (2010) 55-60.
  2. 10Walt, J.G., Rowe, M.M., and Stern, K.L. Evaluating the functional impact of dry eye: The Ocular Surface Disease Index. Drug Inf J. 1997; 31: 1436
  3. Blackie C, Albou-Ganem C, Korb D. Questionnaire assists in dry eye disease diagnosis. Four-question survey helps evaluate patients’ dry eye symptoms to improve screening. Ocular Surgery News Europe Edition. November 2012.
  4.  13Gulati, A., Sullivan, R., Buring, J.E. et al. Validation and repeatability of a short questionnaire for dry eye syndrome. Am J Ophthalmol. 2006; 142: 125–131