Association between dry eye symptoms and signs

PURPOSE: To evaluate the association between subjective dry eye symptoms and the results of the clinical examinations. METHODS: The study was a clinical-based survey involving 215 first-year students selected consecutively during a regular ocular health examination at the University of Cape Coast Optometry Clinic. The data collection process spanned for a period of four months. Out of the 215 students, 212 returned their completed questionnaires and were subsequently included in the study. Dry eye tests including meibomian gland assessment, tear break up time, fluorescein staining, Schirmer test, and blink rate assessment, were performed on each subject after completion of the Ocular Surface Disease Index (OSDI) questionnaire. Shapiro–Wilk test was used to determine the normality of the clinical tests, and Spearman's correlations co-efficient was used to determine the correlations between the clinical test results and dry eye symptoms. RESULTS: Statistically significant associations were found between OSDI scores and blink rate (r(s) = 0.140; P < 0.042), and associations between OSDI scores and contrast sensitivity scores (r(s) = 0.263; P < 0001). However, the results of corneal staining (r(s) = −0.006; P < 0.926), Schirmer test (r(s) = −0.033; P = 0.628), tear break up time (r(s) = −0.121; P < 0.078), meibomian gland expressibility (r(s) = 0.093; P < 0.180), and meibomian gland quality (r(s) = 0.080; P < 0.244) showed no significant association with OSDI. The correlation coefficients range from −0.006 to 0.263 showed low to moderate correlation between dry eye symptoms and the results of clinical test. CONCLUSION: Associations between dry eye symptoms and clinical examinations are low and inconsistent, which may have implications for the diagnoses and treatment of dry eye disease.