Dry-eye screening by using a functional visual acuity measurement system: the Osaka Study.

Area of Science:

• Ophthalmology
• Digital Health
• Public Health

Background:

• Digital screens are ubiquitous in modern life.
• Prolonged use of visual display terminals (VDTs) is associated with digital eye strain and dry eye disease (DED).
• Accurate prediction of DED in VDT users is crucial for early intervention.

Purpose of the Study:

• To evaluate if functional visual acuity (VA) parameters and a dry eye symptoms questionnaire can predict DED in VDT users.
• To assess the diagnostic performance of these parameters individually and in combination.

Main Methods:

• A prospective study of 491 VDT users.
• Classification into definite or probable DED groups based on symptoms, tear film stability (tear breakup time - TBUT), and corneal staining.
• Assessment of functional VA parameters and administration of a DED symptoms questionnaire.
• Univariate and discriminant analyses to predict DED group allocation.

Main Results:

• The study included 320 individuals in the DED group and 171 in the non-DED group.
• Tear breakup time (TBUT) was significantly lower in the DED group (3.1s vs. 5.9s).
• A discriminant equation combining functional VA and questionnaire data achieved an Area Under the Curve (AUC) of 0.735, with 85.9% sensitivity and 45.6% specificity for DED prediction.

Conclusions:

• A discriminant equation integrating functional VA measurements and a dry eye symptoms questionnaire shows potential as an initial screening tool for DED, particularly for individuals with unstable tear film.
• The current questionnaire demonstrates suboptimal sensitivity and specificity, necessitating further improvements for effective clinical implementation.