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Updated: Jul 3, 2025
Comparing Objective Conjunctival Hyperemia Grading and the Ocular Surface Disease Index Score in Dry Eye Syndrome During COVID-19
Published on: May 25, 2022
Symptomatic dry eye disease among university students
Khalid M Al-Zubi1, Waqar A Al-Kubaisy2, Yazan E Al-Azzeh3
1Department of Ophthalmology, Faculty of Medicine, Mu'tah University, Mu'tah, Jordan.
Background:
Dry eye disease (DED) is a multifactorial condition often characterized by a reduction in tear film quantity or quality. This study aimed to determine the frequency of DED and its associated subjective symptoms among students of Mu'tah University.
Methods:
In this cross-sectional study conducted at Mu'tah University, Mu'tah, Jordan, from January to April 2022, 489 students completed an online patient-reported DED symptom questionnaire and the ocular surface disease index (OSDI) questionnaire. Moreover, 106 participants underwent clinical examinations using the Schirmer test I and fluorescein tear breakup time (TBUT).
Results:
Approximately 74.6% of the students self-reported experiencing DED symptoms, and 72.6% had an OSDI score > 12, which is considered the threshold for an abnormal ocular surface. Clinical examinations revealed low Schirmer test scores ( < 10 mm) in 26.4% (n = 28) and 25.5% (n = 27) of the right and left eyes, respectively. We observed low TBUT scores ( < 5 s) in 19.8% (n = 21) and 18.9% (n = 20) of the right and left eyes, respectively. We noted significant differences between the self-reported DED symptoms and the Schirmer test scores (P = 0.003 for both right and left eyes), TBUT (P < 0.001 for both right and left eyes), and OSDI score (P < 0.001 for each self-reported DED symptom). We observed a weak significant positive correlation between Schirmer test scores and TBUT in the right (r = + 0.30; P = 0.002) and left (r = + 0.34; P < 0.001) eyes; a negligible significant inverse correlation between OSDI scores and Schirmer test scores in the right (r = - 0.24; P = 0.013) and left (r = - 0.23; P = 0.019) eyes; and a negligible significant inverse correlation between the OSDI score and TBUT of the left eye (r = - 0.25; P = 0.011) but not of the right eye (r = - 0.17; P = 0.077).
Conclusions:
The frequency of DED symptoms in this study was higher than that previously reported based on foreign statistics. The presence of self-reported DED symptoms was significantly associated with higher OSDI scores. Self-reported DED symptoms were more frequent than the abnormalities detected using objective methods. Therefore, a combination of subjective and objective measures may provide higher diagnostic yield for DED. Further studies are required to confirm this hypothesis.
