With dry eye disease (DED) pervasive in populations around the world, researchers from the UK recently documented the burden brought on by the condition for individuals, healthcare systems and employers.

Participants in this cross-sectional, web-based assessment—the largest DED survey completed in the UK—included roughly 1,000 adults age 18 and older with DED and the same number without it. They completed several questionnaires, including the National Eye Institute’s  25-item Visual Function Questionnaire (VFQ), the Standardized Patient Evaluation of Eye Dryness (SPEED), the Ocular Comfort Index (OCI) and the Eye Dryness Score (EDS). Baseline demographic and clinical characteristics were similar in participants with vs. without DED.

Subjects were categorized into three groups according to their EDS result, with a higher score indicating greater severity. Those in group 3 had the highest level of discomfort for all symptoms related to DED (e.g., eye discomfort, tired eyes and itching eyes) and a greater impact on activities and socioemotional functioning, assessed by VFQ. Mean VFQ scores were lower in participants with DED, indicating activity limitations and worse socioemotional functioning. Higher percentages of problems and the inability to complete activities were observed among those with vs. without DED. The impact of DED on visual function was worse for participants with more severe DED symptoms, as assessed by EDS. In addition, a higher EDS was associated with worse symptoms on common DED scales and a worse impact on work productivity.

A similar trend was seen for other questionnaires. Participants with higher severity as assessed by EDS had a higher severity and frequency of symptoms as assessed by mean DEQ-5 scores. Participants with higher severity also had higher mean SPEED scores, indicating more frequent and/or more severe symptoms.

The study concludes DED symptoms are associated with negative impacts to socioemotional functioning, vision-related quality of life function, daily activities and work productivity, and participants with worse DED symptoms had an even greater decline in those functions and activities.

“The results of this study suggest the usefulness of the EDS as a single score to assess the severity of dry eye symptoms in individuals with DED,” the authors noted in their paper. “Compared with other common DED symptom scales, a higher EDS (indicating more discomfort) was associated with worse symptoms on the OCI, DEQ-5 and SPEED. Additional analyses should be performed to confirm the reliability of the EDS to discriminate between different levels of DED severity.”

The authors also noted there were some limitations of this study. For example, because it was a cross-sectional study, they could not assess whether the vision-related quality of life was low prior to a diagnosis of DED and whether vision-related qualify of life changed over time.

Hossain P, Siffel C, Joseph C, et al. Patient-reported burden of dry eye disease in the UK: a cross-sectional web-based survey. BMJ Open 2021; 11e03209. doi: 10.1136/bmjopen-2020-039209.