Dry eye disease (DED) is highly subjective and, although several clinical markers have been established, patients routinely report symptoms that aren’t correlated with signs. Conversely, patients can show signs but not experience symptoms. This elusiveness makes DED tough to track, as some treatments can help reduce symptoms but not address underlying problems and others can register as successful in reducing clinical signs while the patient continues to experience symptoms. To help establish the success of treatments, a Spanish research team proposes a two-question survey, which they dubbed the Change in Dry Eye Symptoms Questionnaire (CDES-Q).

The CDES-Q is meant as a simplified version of the Symptoms Assessment Questionnaire in Dry Eye (SANDE) version II, which the team called “somewhat complex.” And they’re not the only ones who think that. Even the team behind SANDE noted that subjects reported difficulties filling in the questionnaire, especially when asked to accurately reflect their current or previous eye status. The simplified CDES-Q asks patients to (1) describe: their change in symptoms (better, same or worse) relative to their previous visit and (2) quantify the change on a scale of zero to 10. 

The team evaluated 36 patients with the CDES-Q, the SANDE II and the Ocular Surface Disease Index questionnaires. At 90 days, all three showed a significant reduction in symptoms. Patients who answered “better” in CDES-Q’s first question showed a significantly lower SANDE II than those who answered “same” or “worse,” while SANDE II did not discriminate between these groups, showing better specificity.

The researchers wrote this shows CDES-Q is useful for evaluating changes in DED-related symptoms due to its simplicity and it was superior to SANDE II in distinguishing patients without changes from those who got worse.

Pinto-Fraga J, Calonge M, Enríquez-de-Salamancea A, et al. Development of a questionnaire for detecting changes in dry eye disease–related symptoms. Eye & Contact Lens. February 24, 2020. [Epub ahead of print].