Dry Eye Symptom Severity and Visual Field Reliability Metrics.

Area of Science:

• Ophthalmology
• Optometry
• Glaucoma Research
• Dry Eye Disease

Background:

• Dry eye disease is prevalent in glaucoma patients and can worsen with topical glaucoma medications.
• Dry eye symptoms may compromise the reliability of visual field (VF) testing, impacting diagnostic accuracy.
• Gaze tracking (GT) offers advanced metrics for assessing VF test reliability.

Purpose of the Study:

• To investigate the association between dry eye symptom severity and VF reliability metrics, including standard measures and GT metrics.
• To determine if tracking failure frequency (TFF), a GT metric, correlates with dry eye severity and laterality in glaucoma patients.

Main Methods:

• 494 glaucoma patients completed a dry eye questionnaire before VF testing.
• VF reliability was assessed using standard metrics (fixation losses, false positives/negatives) and GT metrics (including TFF).
• Data on glaucoma medication and artificial tear use were collected.

Main Results:

• Tracking failure frequency (TFF) significantly increased with greater dry eye symptom severity (P=0.015).
• TFF was also significantly higher in the left eye, which was tested second (P=0.012).
• No significant associations were found between dry eye severity and standard VF reliability metrics or most GT metrics.

Conclusions:

• Dry eye symptom severity may necessitate adjusted thresholds for TFF when interpreting VF reliability using GT.
• The acceptable range for TFF might differ between the right and left eyes.
• Further research is needed to establish specific TFF thresholds for glaucoma patients with varying degrees of dry eye.