PT  - JOURNAL ARTICLE
AU  - Anat Galor
AU  - Elizabeth R Felix
AU  - William Feuer
AU  - Nabeel Shalabi
AU  - Eden R Martin
AU  - Todd P Margolis
AU  - Constantine D Sarantopoulos
AU  - Roy C Levitt
TI  - Dry eye symptoms align more closely to non-ocular conditions than to tear film parameters
AID  - 10.1136/bjophthalmol-2014-306481
DP  - 2015 Feb 20
TA  - British Journal of Ophthalmology
PG  - bjophthalmol-2014-306481
4099  - http://bjo.bmj.com/content/early/2015/02/20/bjophthalmol-2014-306481.short
4100  - http://bjo.bmj.com/content/early/2015/02/20/bjophthalmol-2014-306481.full
AB  - Objective To evaluate the relationship between dry eye symptoms, non-ocular conditions and tear film parameters. Methods Design: Cross-sectional study. Participants/setting: The study population consisted of patients who were seen in the Miami Veterans Affairs eye clinic. Patients filled out standardised questionnaires assessing dry eye symptoms (dry eye questionnaire 5 (DEQ5) and ocular surface disease index (OSDI)), non-ocular pain, depression and post-traumatic stress disorder (PTSD), and also underwent measurement of tear film parameters. Main outcome measures: Correlations between dry eye symptoms and non-ocular conditions as compared with tear film parameters. Results 136 patients with a mean age of 65 (SD 11) years participated in the study. All correlations between the dry eye questionnaire scores (DEQ5 and OSDI) and (A) self-reported non-ocular pain measures (numerical rating scale and pain history), (B) depression and (C) PTSD were significant and moderate in strength (Pearson's coefficient 0.24 to 0.60, p<0.01 for all). All correlations between the dry eye questionnaires and tear film measures were weak (Pearson's coefficient −0.10 to 0.18) and most were not significant. Multivariable linear regression analyses revealed that PTSD and non-ocular pain more closely associated with dry eye symptoms than did tear film parameters. Specifically, non-ocular pain and PTSD accounted for approximately 36% of the variability in DEQ5 scores (R=0.60) and approximately 40% of variability in OSDI scores (R=0.64). Of note, none of the tear parameters remained significantly associated with dry eye symptoms in either model. Conclusions Dry eye symptoms more closely align to non-ocular pain, depression and PTSD than to tear film parameters.