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Current patterns in the use of diagnostic tests in dry eye evaluation
Janine Smith1, Kelly K Nichols, Edward K Baldwin
1National Eye Institute/NIH/DHHS, Bethesda, MD, USA.
Cornea
|June 27, 2008
Summary
Patient-reported symptoms and objective clinical signs are crucial for diagnosing and managing dry eye disease. However, current diagnostic tests often fail to correlate reliably with symptom severity, necessitating further research.
Area of Science:
- Ophthalmology
- Clinical diagnostics
Background:
- Dry eye disease diagnosis and management involve both objective signs and subjective symptoms.
- A notable discrepancy often exists between reported symptoms and observed clinical signs in dry eye patients.
- Current clinical practices and the precise roles of signs versus symptoms in dry eye management remain subjects of debate.
Purpose of the Study:
- To elucidate the utilization of objective signs and subjective symptoms in dry eye diagnosis and management by expert practitioners.
- To understand how clinicians integrate symptom and sign assessments in their clinical decision-making process for dry eye.
Main Methods:
- A scientific roundtable convened 16 dry eye experts.
- Participants reviewed four distinct patient case studies.
- Expert practitioners completed surveys, ranking diagnostic procedures for assessing dry eye signs and symptoms by their order of use.
Main Results:
- Symptom assessment emerged as the primary diagnostic approach.
- Key objective tests frequently employed in initial examinations included tear breakup time (93%), corneal staining (85%), tear film assessment (76%), conjunctival staining (74%), and the Schirmer test (54%).
- The median number of diagnostic tests utilized by panelists during initial examinations was six, indicating a comprehensive approach.
Conclusions:
- Both subjective patient-reported symptoms and objective clinical signs are integral to the diagnosis and management of dry eye.
- Patient history and symptom reporting play a pivotal role in the diagnostic and management pathway.
- Existing diagnostic tests for dry eye show limitations in reliably correlating with symptom severity, highlighting a need for improved, objective, and responsive diagnostic measures.
