Original article
Impact of Ocular Surface Symptoms on Quality of Life in a United States Veterans Affairs Population

https://doi.org/10.1016/j.ajo.2011.11.030Get rights and content

Purpose

To evaluate the impact of ocular surface symptoms on quality of life in a veteran population receiving eye care services.

Design

Cross-sectional survey study.

Methods

setting: Miami Veterans Affairs Medical Center (VAMC). patient population: Patients seen at the eye clinic between June and August 2010 were asked to fill out the Dry Eye Questionnaire 5 (DEQ5) and the Impact of Dry Eye on Everyday Life (IDEEL) questionnaire. main outcome measures: Correlation between ocular surface symptoms and functionality.

Results

Four hundred eighty-nine patients elected to fill out the DEQ5 questionnaire (36% response rate). The mean age of respondents was 66 years (standard deviation 12). Ninety-four percent were male; 62% were white and 37% were black. Using the DEQ5 as a surrogate measure of ocular surface symptoms, 65% of respondents reported at least mild ocular surface symptoms (DEQ5 ≥6) and 27% of them reported severe symptoms (DEQ5 ≥12). Black subjects had a 2-fold increased risk of severe symptoms compared to white subjects (odds ratio 2.06, 95% confidence interval 1.33-3.19). Several medications were associated with a significantly increased risk of severe symptoms, including glaucoma medications (1.7-fold increase), antidepressants (2.3-fold increase), and antihistamines (2.1-fold increase). There was an inverse correlation between DEQ5 and IDEEL scores with regard to ability to perform activities of daily living (n = 391, r = −0.54, P < .001), emotional well-being (n = 386, r = −0.63, P < .001), and the ability to work (n = 205, r = −0.57, P < .001). Fifty percent of patients with severe symptoms had documentation that their symptoms were addressed during the visit.

Conclusion

Severe ocular surface symptoms reduce the quality of life of Miami VAMC veterans. Eye care professionals should be vigilant in eliciting ocular surface complaints from their patients.

Section snippets

Study Population

Patients seen in VA clinics consist of ex-military personnel but do not include or represent all former military recruits. The Miami VA eye clinic serves veterans with specific eye problems along with those needing surveillance because of medical conditions (eg, diabetes). Patients seen in the Miami VA eye clinic (by an ophthalmologist or optometrist) between June and August 2010 were invited to complete 2 questionnaires at the time of their visit, the Dry Eye Questionnaire 5 (DEQ5) and the

Respondents' Population

Four hundred eighty-nine patients elected to fill out the DEQ5 questionnaire at the time of their eye clinic visit, with no statistically significant differences on select sociodemographic characteristics between study participants and those who did not complete the questionnaire (Table 1). Mean respondent age was 66 years (range 23 to 95 years, standard deviation [SD] 12). Ninety-four percent were male; 62% were white and 15% were Hispanic. Among respondents with available clinical histories

Discussion

The goal of this study was to assess how ocular surface symptoms impact the QoL of a Miami veteran eye care population. We found that the presence of ocular surface symptoms negatively impacted the performance of daily activities, emotional well-being, and capacity to work. Furthermore, while this was not designed as a prevalence study, we found that a significant proportion (27%) of patients who elected to fill out the questionnaires reported having severe symptoms. Even under the unlikely

Bozorgmehr Pouyeh, MD, is a pre-residency research fellow at Bascom Palmer Eye Institute (BPEI) and Miami Veteran Affair Medical Center (VAMC). He completed his medical education in Iran at Tehran University of Medical Sciences. He has collaborated with faculty of BPEI and Miami VAMC on various projects on dry eye, DSAEK, and fungal keratitis and introduced innovative ways of automating data collection. He envisions to expand his work by implementing solutions for the diagnosis of challenging

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Bozorgmehr Pouyeh, MD, is a pre-residency research fellow at Bascom Palmer Eye Institute (BPEI) and Miami Veteran Affair Medical Center (VAMC). He completed his medical education in Iran at Tehran University of Medical Sciences. He has collaborated with faculty of BPEI and Miami VAMC on various projects on dry eye, DSAEK, and fungal keratitis and introduced innovative ways of automating data collection. He envisions to expand his work by implementing solutions for the diagnosis of challenging ophthalmic conditions such as fungal keratitis.

Anat Galor, MD, is an Assistant Professor of Clinical Ophthalmology at the Bascom Palmer Eye Institute and a staff physician at the Miami VAMC. She completed an ophthalmology residency at the Cleveland Clinic Cole Eye Institute, followed by a uveitis fellowship at Wilmer Eye Institute and a cornea fellowship at Bascom Palmer Eye Institute. Dr Galor's research interests focus on understanding the pathophysiology and improving treatment outcomes of ocular surface conditions including dry eye syndrome, ptergyium, and conjunctival intraepithelial neoplasia.

Supplemental Material available at AJO.com.

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