Introduction: The clinical evaluation of the three layers of tear film is still poorly described. The purpose of this study is to evaluate the value of aqueous assessment in diagnosing dry eye.
Materials and method: Schirmer test with anaesthesia (STA) and tear meniscus height (TMH) measurement were conducted on non-dry eye (NDE) and dry eye (DE) subjects in this cross-sectional study. The NDE and DE subjects were classified using two types of classification; classification 1 and classification 2.
Results: 321 subjects with 642 eyes were recruited in the study. STA was significantly correlated with TMH (r = 0.24, p < 0.001) in all 642 eyes. The comparison between nondry and dry eye subjects in STA and TMH were not significantly different (p > 0.05) if the Classification 1 was used to define dry eye. In Classification 2, there were significantly different between NDE (12.5 ± 8.2 mm) and DE (3.4 ± 0.8 mm) subjects in STA (p < 0.001). Similar trend was also depicted in TMH based on the definition of dry eye stated in Classification 2 (NDE = 0.45 ± 0.20 mm, DE = 0.39 ± 0.14 mm; p < 0.05).
Conclusion: The value of STA and TMH were lower significantly in dry eye subjects. However, the significant outcomes were only demonstrated if the clinical signs of dryness were used in the definition of dry eye.
Introduction: There was no previous study to assess relationship between dry eye symptoms and signs in the local population. The purpose of this study is to evaluate the relationship of symptomatic assessment and clinical signs of dryness in dry eye subjects.
Materials and method: A Cross-sectional study with convenient sampling involving 321 subjects with 642 eyes was done. Subjects were divided into non-dry eye (NDE) and dry eye (DE) groups. The division of NDE and DE groups were done using two types of classification. In Classification 1(symptoms-based), DE was defined if the score of Ocular Surface Disease Index (OSDI) score was more than 33. The value of tear film break-up time (TFBUT) less than 5 seconds and Schirmer test with anaesthesia (STA) less than 5mm/5 minutes were considered as DE for Classification 2 (signs based).
Results: There were poor correlations between OSDI and clinical signs of dryness in all subjects involved (p > 0.05). Similar findings were also noted within NDE subjects in Classification 1 and Classification 2. OSDI score was also not significantly correlated with the signs of dryness within DE subjects except with ocular protection index (OPI) (r = - 0.14, p = 0.047) in Classification 1 and with conjunctival lissamine green staining (CLGS) (r = 0.23, p = 0.040) in Classification 2.
Conclusion: There were no significant correlation between the symptoms of dry eye and the clinical signs of dry eye. Therefore, the clinical diagnosis of dry eye can be made based on either just on the symptoms or the signs.