The Berkeley Dry Eye Flow Chart: A fast, functional screening instrument for contact lens-induced dryness

Abstract

PurposeIn this article, we introduce a novel flow chart-based screening tool for the categorization of contact lens-induced dryness (CLIDE) and its impact on daily visual activities: the Berkeley Dry Eye Flow Chart (DEFC).MethodsOne hundred thirty (130) experienced soft contact lens wearers discontinued lens wear for 24 hrs, passed a baseline screening and eye health examination, completed the Ocular Surface Disease Index (OSDI) then were dispensed fresh pairs of their habitual lenses. After 6 hrs of wear, subjects were administered a battery of symptom questionnaires, and underwent non–invasive tear breakup time (NITBUT) measurement, grading of distortion in reflected topographer mires, grading of lens surface wettability, and a fluorescein examination of the ocular surface. Subjects returned after at least 48 hrs and repeated all assessments after 6 hrs of wear of a second fresh pair of habitual lenses.ResultsThe repeatability of the DEFC between visits was within 1%, and Limits of Agreement and Coefficient of Repeatability were comparable to those of the other CLIDE assessments. Higher DEFC score was significantly related to shorter pre-lens NITBUT, higher OSDI score, and higher Visual Analog Scale (VAS) ratings of average and end-of-day severity and frequency of dryness (all p < 0.001). For CLIDE as diagnosed based on DEFC score, the highest sensitivities and specificities were achieved by the OSDI and VAS ratings; pre-lens NITBUT exhibited good sensitivity but poor specificity. The optimum pre-lens NITBUT diagnostic threshold was found to be ≤ 2.0 sec for debilitating CLIDE, and the OSDI threshold was ≥ 11.4.ConclusionsThe DEFC provides a means of quickly categorizing CLIDE patients based on severity and frequency of symptoms, and on the degree to which symptoms impact daily life. The DEFC has several potential advantages as a CLIDE screening and monitoring tool, has good repeatability, and is significantly related to commonly employed clinical assessments for CLIDE.

Sex Disparity in How Pain Sensitivity Influences Dry Eye Symptoms

“…The subjects were administered a battery of questionnaires composed of the Ocular Surface Disease Index (OSDI), Berkeley Dry Eye Flow Chart (DEFC), Standardized Patient Evaluation of Eye Dryness (SPEED), and 100point visual analog rating scales for average daily comfort (0 = "poor comfort, intolerable," 100 = "excellent comfort") and average daily dryness (0 = "no sensation of dryness whatsoever," 100 = "extremely dry, intolerable"). 18 Although there is a significant overlap of symptom assessment in dry eye between the questionnaires, they were included because they likely provide different dimensions and insights on the symptoms experienced by the subjects. 19 The subjects were also asked to complete the PSQ, which has been validated in normal and chronic pain populations and in ocular surface research.…”

The expression of miRNA‐146a‐5p and its mechanism of treating dry eye syndrome

“…Dry eye syndrome refers to a general term for a type of disease in which the composition and volume of tears or abnormalities in kinetics cause instability of the tear film, accompanied by eye discomfort such as dryness, 18 visual fatigue, 19 photophobia, 20 and decreased vision 21 . In terms of classification, it is a kind of chalk disease; that is, there is no abnormality in appearance and the patient has obvious eye discomfort.…”

The expression of miRNA-146a-5p and its mechanism of treating dry eye syndrome

“…Dry eye syndrome refers to a general term for a type of disease in which the composition and volume of tears or abnormalities in kinetics cause instability of the tear lm, accompanied by eye discomfort such as dryness [18], visual fatigue [19], photophobia [20], and decreased vision [21]. In terms of classi cation, it is a kind of chalk disease, that is, there is no abnormality in appearance and the patient has obvious eye discomfort.…”