Dry Eye Form
Comparative Study of use of ‘Questionnaire’ & ‘Diagnostic’ method for dry eye
Comparative Study of use of ‘Questionnaire’ &
‘Diagnostic’ method for dry eye
Introduction
Nowadays, dry eye is very rapidly growing problem. Many times ophthalmologists have to investigate with various diagnostic tests to label a patient with ‘Dry eye syndrome’. Many patients in OPD & camps are suspected for dry eye but it is practically very difficult to perform diagnostic tests for each patient. Diagnostic tests have their own limitations as cost of equipments & portability. If such equipment is available, then there is a need of trained hand for examination. If Schirmer test is taken into consideration, it also has its own limitations as it should be carried out with proper precautions. To overcome such difficulty, a questionnaire can be provided to OPD / camp patients for assessment of dry eye.
Aim
To study the efficacy of Questionnaire method against Diagnostic method for dry eye.
Objective
To prove the efficacy of Questionnaire
To find simple method for diagnosis of dry eye which can be used by untrained person & can be used for mass screening of dry eye.
Materials & methods
A 209 students from a class of IT faculty were selected randomly after there consent. A Questionnaire was provided to these students. For positive response, the score is ‘2′ & ‘one’ for negative response, total score is noted. Then same students were tested for Schirmer II test & findings recorded.
Schirmer Test
The Schirmer I test without anesthetic is a test of reflex secretion in response to conjunctival stimulation. It is a useful test for the evaluation of dry eye. The reliability of the test may be affected by environmental conditions such as temperature & humidity.
The Schirmer I test can be performed after instillation of a topical anesthetic, and it has been assumed to measure the basal secretion rate in the absence of a reflex component. Nasal anesthesia reduces the Schirmer value obtained from the test.
The Schirmer II test assesses reflex secretion of tears in response to nasal stimulation in addition to the conjunctival stimulation. Wetting of the strip in response to this test has been shown to be reduced in the more severe forms of dry eye. These Schirmer strips are hygienically formulated and individually packed as per the medical standards.
Following is the usage procedure of these strips:
- Stored at room temperature
- Put back the used strips into the pouch and incinerated for disposal
- Do not use if the individual packing have been damaged or previously opened
Schirmer Test Score
0 Normal – Schirmer Test 15mm-30mm
1 Mild – Schirmer Test 15mm-10mm
2 Moderate – Schirmer Test 06mm-10mm
3 Severe – Schirmer Test 00mm-05mm
Questionnaire
- Since how long are you suffering from discomfort in eyes?
1 – Less than 3 month 2 – More than 3 month
- Is it unilateral or bilateral?
1 – Unilateral 2 – Bilateral
- Smoking habit?
2 – Yes 1 – No
- Use of contact lens more frequently?
2 – Yes 1 – No
- Direct air flow of fan or Air Condition on eye?
2 – Yes 1 – No
- Use of Visual Display Terminal like Computer, TV, Mobile more than 3hrs a day?
2 – Yes 1 – No
- Working with outdoor activity?
2 – Yes 1 – No
- Medical history like Rheumatoid arthritis?
2 – Yes 1 – No
- Working with regular night duty?
2 – Yes 1 – No
- Less water intake?
2 – Yes 1 – No
Questionnaire Score
Normal Score equal or less than 10
Mild Score equal or less than 14
Moderate Score equal or less than 18
Sever Score more than 18
Observation
Schirmer II test % Score %
Normal 60% 65%
Mild 21% 17%
Moderate 13% 13%
Sever 6% 5%
Results
There is very minimal difference in observations of Schirmer II test & Questionnaire score.
Conclusion
This Questionnaire can be used in mass scale survey of dry eye because it has good efficacy as tested against Schirmer II test
It is very safe, simple in implementing & cost effective.
There is no need of trained person for testing.
It can be a good utilization of the waiting period of OPD patients.
About the Author
Dr.Prashant B Thorat
MS Netraraog
YMT Medical College, Kharghar,
Navi Mumbai
09769432224
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