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Characterization of Ocular Surface Symptoms From Optometric Practices in North America

Begley, Carolyn G. O.D., M.S.; Chalmers, Robin L. O.D.; Mitchell, G. Lynn M.A.S.; Nichols, Kelly K. O.D., M.P.H., Ph.D.; Caffery, Barbara O.D., M.S.; Simpson, Trefford Ph.D.; DuToit, Renee Mphil.Optom.; Portello, Joan O.D., M.P.H.; Davis, Larry O.D.

Clinical Sciences

Purpose. This study characterized ocular symptoms typical of dry eye in an unselected optometric clinical population in the United States and Canada.

Methods. Self-administered dry eye questionnaires, one for non–contact lens wearers (dry eye questionnaire) and one for contact lens wearers (contact lens dry eye questionnaire), were completed at six clinical sites in North America. Both questionnaires included categoric scales to measure the prevalence, frequency, diurnal severity, and intrusiveness of nine ocular surface symptoms. The questionnaires also asked how much these ocular symptoms affected daily activities and contained questions about computer use, medications, and allergies. The examining doctors, who were masked to questionnaire responses, recorded a nondirected dry eye diagnosis for each patient, based on their own diagnostic criteria.

Results. The dry eye questionnaires were completed by 1,054 patients. The most common ocular symptom was discomfort, with 64% of non–contact lens wearers and 79% of contact lens wearers reporting the symptom at least infrequently. There was a diurnal increase in the intensity of many symptoms, with symptoms such as discomfort, dryness, and visual changes reported to be more intense in the evening. The 22% percent of non–contact lens wearers and 15% of contact lens wearers diagnosed with dry eye (most in the mild to moderate categories) reported symptoms at a greater frequency than those not diagnosed with dry eye.

Conclusions. Our results show that symptoms of ocular irritation and visual disturbances were relatively common in this unselected clinical population. The intensity of many ocular symptoms increased late in the day, which suggested that environmental factors played a role in the etiology of the symptoms.

From Indiana University School of Optometry (C.G.B.); Atlanta, Georgia (R.L.C.); The Ohio State University College of Optometry (G.L.M., K.K.N.); Toronto, Ontario (B.C.); University of Waterloo School of Optometry (T.S., R.D.); State University of New York School of Optometry (J.P.); and University of Missouri School of Optometry (L.D.).

Submitted November 27, 2000.

Revision received March 14, 2001.

Accepted March 21, 2001.

Address correspondence and reprint requests to Dr. C.G. Begley, School of Optometry, Indiana University, 800 East Atwater Street, Bloomington, IN 47405, U.S.A.

© 2001 Lippincott Williams & Wilkins, Inc.