A Continuing Education Review for Optometrists from New England College of Optometry Dry Eye Symptomatology and Pathophysiology: New Understandings

Symptom Assessment DED patients may experience a variety of symptoms: discomfort, blurred vision, dryness, irritation, and, in some cases, just awareness of their eyes. These ocular surface symptoms are nonspecifi c and often not self-reported. To identify suspect DED and establish the need for further assessment, a good fi rst step is to ask patients how their eyes feel and what kind of symptom triggers they experience (eg, environmental or certain medications). The TFOS DEWS II report recommends an initial symptom survey be conducted using the Ocular Surface Disease Index (OSDI) or the 5-item Dry Eye Questionnaire (DEQ-5).1 Both DED questionnaires are relatively short and ask questions about eye irritation, dryness, and visual changes. The questionnaire can be administered by staff at the beginning of a visit. Then, when interacting with a patient, the eye care provider can encourage him or her to talk more about any symptoms by asking how often the symptoms occur, when they occur, and whether they impact the patient’s daily activities.