Diagnosing the severity of dry eye: a clear and practical algorithm

Abstract

Dry eye disease (DED) is a distressing ocular condition. Due to its multifactorial nature, clinical and biological signs of DED can be inconsistent and sometimes discordant with symptomatology. Consequently, no gold-standard model for determining DED severity exists. This can impact treatment decisions and complicate evaluation of disease progression, particularly within the stringent context of clinical trials. The multinational ODISSEY European Consensus Group is comprised of ophthalmologists who contend with ocular surface disease issues on a daily basis. This group convened to establish a clear and practical algorithm for evaluation and diagnosis of severe DED. Using a consensus-based approach, they assessed 14 commonly used DED severity criteria. The panel agreed that following confirmed DED diagnosis, just two criteria, symptom-based assessment and corneal fluorescein staining were sufficient to diagnose the presence of severe DED in the majority of patients. In the event of discordance between signs and symptoms, further evaluation using additional determinant criteria was recommended. This report presents the ODISSEY European Consensus Group recommended algorithm for DED evaluation, which facilitates diagnosis of severe disease even in the event of discordance between signs and symptoms. It is intended that this algorithm will be useful in a clinical and developmental setting.

Patients' perception of DED and its relation with time to diagnosis and quality of life: an international and multilingual survey

“…Dry eye disease (DED) is a multifactorial disease affecting 6–34% of adults worldwide,1 2 yet it is often underdiagnosed or misdiagnosed and inadequately treated, despite the risk of ocular damage 2 3. The direct cost of DED has been estimated between $300 and $1100 per patient annually, with additional costs due to impaired work productivity, and economic impact on healthcare systems being similar to rheumatoid arthritis 4–6…”

Dry Eye In Welders Of Puducherry: A Rising Occupational Hazard

“…However, if untreated, it can cause permanent damage to the tear film. 4 Dry eye adversely affects vision and thereby hinders daily activities such as reading, driving, sports and recreational activities. 5 The common symptoms are foreign body sensation, blurred vision, redness, photophobia and burning sensation.…”

A Comparative Study to Evaluate the Efficacy of Carboxy Methyl Cellulose with Glycerin and Balanced Electrolytes as excipients vs Plain Carboxy Methyl Cellulose, for keeping the eye moist

“…1 Abnormality of any one of the three layers of tear film produces an unstable tear film, resulting in discomfort of DES. 2 Symptoms of dry eye vary among patients, and most commonly they include itching, grittiness, burning, sensitivity to bright light, foreign-body sensation, irritation, pain, blurred vision, and contact lens intolerance. In severe cases, dry eye disease can also lead to permanent visual impairment.…”

“…3 DES is a common ocular condition which significantly reduces quality of life, and affects 6-34% of the global adult population. 2 Women…”