The Diagnostic Value and Accuracy of Conjunctival Impression Cytology, Dry Eye Symptomatology, and Routine Tear Function Tests in Computer Users

Abstract

Aims and Objectives:To compare the diagnostic value and accuracy of dry eye scoring system (DESS), conjunctival impression cytology (CIC), tear film breakup time (TBUT), and Schirmer's test in computer users.Methods:A case–control study was done at two referral eye centers. Eyes of 344 computer users were compared to 371 eyes of age and sex matched controls. Dry eye questionnaire (DESS) was administered to both groups and they further underwent measurement of TBUT, Schirmer's, and CIC. Correlation analysis was performed between DESS, CIC, TBUT, and Schirmer's test scores. A Pearson's coefficient of the linear expression (R2) of 0.5 or more was statistically significant.Results:The mean age in cases (26.05 ± 4.06 years) was comparable to controls (25.67 ± 3.65 years) (P = 0.465). The mean symptom score in computer users was significantly higher as compared to controls (P < 0.001). Mean TBUT, Schirmer's test values, and goblet cell density were significantly reduced in computer users (P < 0.001). TBUT, Schirmer's, and CIC were abnormal in 48.5%, 29.1%, and 38.4% symptomatic computer users respectively as compared to 8%, 6.7%, and 7.3% symptomatic controls respectively. On correlation analysis, there was a significant (inverse) association of dry eye symptoms (DESS) with TBUT and CIC scores (R2 > 0.5), in contrast to Schirmer's scores (R2 < 0.5). Duration of computer usage had a significant effect on dry eye symptoms severity, TBUT, and CIC scores as compared to Schirmer's test.Conclusion:DESS should be used in combination with TBUT and CIC for dry eye evaluation in computer users.

Evaluation of Dry Eye in patients with Psoriasis

“…The authors concluded that tear film tests should be used in combination with dry eye questionnaire for a more accurate dry eye evaluation. The present study found that CIC and DESS hold good diagnostic accuracy for dry eye evaluation in patients with psoriasis [15].…”

“…Power was calculated using DESS to detect clinical significance between cases and controls after data analysis, based on data from previously published study [15]. Taking a lead from this study, power was calculated using primary outcome measure (DESS) and assumptions were as follows: Odds ratio = 9.8, exposed controls= 29%, one-sided alpha risk = 5%, controls / case ratio = 1.07, total exposed=48.3086%, Estimated power= 99.9999%.…”

High incidence of dry eye in young children with allergic conjunctivitis in Southwest China

“…In our study, there was no correlation between TFBUT and the DESS score. However, a study in young adults (25-26 years of age) showed that symptom-based screening using DESS was statistically associated with TBUT (Bhargava et al 2014). One reason for the difference in findings between the age groups may be the limited ability of young children to accurately express the degree and frequency of dry eye symptoms required for the DESS.…”

Management of digital eye strain

“…Dryness and associated symptoms in otherwise healthy eyes are commonly encountered by visual display unit users and have been cited by many investigators. Questionnaire studies have reported that the severity of dry eye is affected by the duration of computer use . Additionally, use of air‐conditioning and forced‐air heating in office environments may contribute to dryness symptoms …”