Signs And Symptoms Correlation In Patients With Dry Eye Disease

To analyze the correlations between the ocular surface signs and reported symptoms in patients with dry eye disease.

Cornea, Cataract and Refractive Surgery Clinic, Unidad Nacional de Oftalmología, Guatemala, Guatemala. 

A cross-sectional study was conducted including patients with dry eye disease evaluated between August and December 2025. Patients underwent computerized dry eye assessment using the Keratograph® (Oculus, Germany), generating a JENVIS report that included tear meniscus height (TMH), non-invasive keratograph break-up time (NIKBUT), meibography (MEIBO), and conjunctival redness grading (CR). Symptom evaluation was performed using the Ocular Surface Disease Index (OSDI) questionnaire. Clinical and demographic variables were recorded, and correlations between OSDI scores and JENVIS report were analyzed. Multivariate analysis and Pearson correlation coefficients were calculated, with statistical significance set at 0.05 alpha value.

One-hundred eyes from 50 patients were analyzed. Mean age was 52.08 ± 15.7 years, 86% female. Mean OSDI score was 19.06 points, corresponding to mild dry eye. JENVIS® report analysis showed a mean TMH of 0.24 and 0.23 mm, mean NIKBUT was 10.7 and 11.1 seconds, while the mean MEIBO score was 1.32 and 1.48 for the right and left eyes, respectively. CR scores were 0.71 and 0.67, for the right and left eyes respectively. No statistically significant correlation was found between symptom severity measured by OSDI and JENVIS report parameters (Pearson r = 0.16, p = 0.26). Multivariate analysis demonstrated that none of the JENVIS parameters significantly predicted patient symptoms according to OSDI symptom categories

This study demonstrates that the signs and symptoms of dry eye disease frequently lack correlation, highlighting the heterogeneous nature of the condition. The use of quality-of-life questionnaires such as the OSDI, together with computerized dry eye analysis, represents an essential component in the comprehensive and individualized evaluation of patients with dry eye disease. Clinically, these findings emphasize that therapeutic decisions should not rely solely on objective parameters, as symptom burden may not be adequately reflected by diagnostic measurements alone, reinforcing the need for a multimodal and patient-centered approach to diagnosis and management.