Comprehensive Overview of Dry Eye Questionnaires for Practice Managers

Dry eye disease affects more than 16 million Americans and their daily activities. Your optometry practice can help patients diagnose dry eye during comprehensive dilated eye exams.

However, sending a dry eye questionnaire to patients before exams is often a more convenient option when diagnosing this common disease. Optometry practices have relied on questionnaires to provide patients with dry eye diagnoses since the 1980s when the McMonnies Questionnaire was introduced.

Discover more about the top dry eye questionnaires for optometry practice managers below.

Understanding Dry Eye Questionnaires

Most optometrists have treated their fair share of dry eye patients, so they usually don’t have trouble diagnosing new cases. Even before a comprehensive dry eye evaluation ends, they can often spot enough signs to diagnose dry eye disease. Outside of dryness, dry eye can lead to a burning sensation, blurry vision, and moderate sensitivity to light.

However, since dry eye disease has become so prevalent, some optometrists spend too much time examining patients for clinical signs. Your optometry clinic can reverse this trend by using a dry eye questionnaire.

Patients can fill one out before appointments when they complain of dry eyes. After reviewing the data patients have provided, optometrists can use each answer to diagnose their condition more efficiently and develop a proper treatment plan.

Definition and Purpose

Dry eye questionnaires are standardized tools optometry practices use to assess severe and moderate dry eye symptoms accurately. The questions in these dry eye syndrome questionnaires quantify subjective experiences by asking patients about the following:

• Dryness
• Discomfort
• Visual disturbances

As long as patients answer questionnaires honestly, this method provides an optometrist with objective data they can use to extend a diagnosis and create a customized treatment plan. This dry eye assessment can also highlight the severity of symptoms and their frequency and pinpoint triggers.

In some cases, an assessment can improve treatment effectiveness for dry eye patients and eliminate any related inconveniences they might face. It can also improve communication between optometrists and their patients and prevent confusion during a patient evaluation.

Types of Dry Eye Questionnaires

The McMonnies Questionnaire was one of the first dry eye questionnaires to emerge in the 1980s following clinical trials. It’s a 14-question symptom assessment for those who suspect dry eye. The questionnaire asks patients whether they wear contact lenses, which dry eye symptoms they’ve seen, how often these symptoms appear, and more.

Although the McMonnies assessment has existed for decades thanks to its consistent clinical findings, it’s still an effective option for optometrists and their patients who wish to have symptoms assessed. But it’s just one of many dry eye questionnaires your practice can use.

Ocular Surface Disease Index (OSDI)

The Ocular Surface Disease Index hasn’t been around as long as the McMonnies Questionnaire. It was established in 2000 by pharmaceutical company Allergan, Inc.

Since then, the OSDI has overtaken the McMonnies assessment as the most often-used questionnaire for dry eye disease. It’s a 12-question assessment broken down into three sections:

1. Ocular symptoms
2. Vision-related function
3. Environmental triggers

Those taking the OSDI are asked to respond to items on the questionnaire with scores between 0 and 4, with 0 indicating they’re suffering from no symptoms and 4 indicating the symptoms are always impacting everyday life. Their corresponding OSDI score will fall between 0 and 100:

• 0-12: No dry eye
• 13-22: Mild dry eye
• 23-32: Moderate dry eye
• 33-100: Severe dry eye

The FDA has pushed doctors to rely more on patient-reported outcomes, and the OSDI helps achieve this goal. Some optometrists have also begun using the OSDI in conjunction with tear break-up time testing to extend more accurate diagnoses. Additionally, Rasch analysis of this assessment suggests it works.

Despite its general effectiveness, the OSDI does have limitations. For instance, it asks patients about certain dry eye symptoms while ignoring others, such as foreign body sensations. Some experts also argue it leans too heavily on the frequency of a patient’s symptoms rather than their severity.

Still, the OSDI has turned into the gold standard for what an effective questionnaire for dry eye disease should be when producing patient-reported outcomes.

Standard Patient Evaluation of Eye Dryness (SPEED)

The OSDI isn’t the only questionnaire to step out of the shadow of the McMonnies Questionnaire. The Standard Patient Evaluation of Eye Dryness (SPEED) was established in 2005 by the ophthalmic medical device manufacturer TearScience, Inc.

The SPEED questionnaire is an even more straightforward eight-question assessment. It asks patients to assess the severity of dry eye symptoms and rate their frequency before providing a score between 0 and 28. These questions focus on the following:

• Eye fatigue
• Soreness
• Scratchiness
• Irritation
• Watering

Despite the differences between the OSDI and SPEED assessments, studies show they’re both effective at helping optometrists diagnose dryness in the eyes, so it’s ultimately a matter of preference.

Other Notable Questionnaires

Several other questionnaires are available to practice managers outside the Ocular Surface Disease Index and SPEED Questionnaire. They include:

• National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ25): Developed in 2001 by the National Eye Institute, this questionnaire is one of the longest assessments, even though it’s a shorter version of the original 51-question test. It features 25 questions designed to determine how dry eye symptoms like irritation impact a patient’s quality of life. They analyze overall health and vision and any difficulties people have with near vision, distance vision, and driving. It operates on a scale of 0 to 100.
• Dry Eye Questionnaire (DEQ): Developed in 2001 by the Texas Eye Research and Technology Center, this questionnaire is also on the longer side. It features 21 questions that mostly deal with the severity of the symptoms a patient is experiencing and their impact on quality of life. It focuses on four main categories, including the degree of irritation and frequency and the intensity of symptoms at the beginning and end of each day.
• Symptom Assessment In Dry Eye (SANDE): Developed in 2007 by researchers from the Schepens Eye Research Institute, this questionnaire has two questions presented as a visual analog scale. It’s designed to assess the severity and frequency of symptoms. It differs from other dry eye assessments, as the SANDE questionnaire calls for patients to answer questions once and again in two months. It’s a reliable way to analyze dry eye symptom changes during daily living.

Other dry eye questions to consider include the Impact of Dry Eye in Everyday Life (IDEEL), the Canadian Dry Eye Epidemiology Study (CANDEES), and the Women’s Health Study Questionnaire. Each has been studied at length in clinical settings.

Implementing Dry Eye Questionnaires in Your Practice

Dry eye affects so many Americans because of the sheer number of factors that cause it. The following patients run the risk of being diagnosed with dry eye:

• Anyone over 50
• Women
• Contact lens wearers
• People with Vitamin A deficiencies
• Those living with Sjögren’s syndrome
• Patients with meibomian gland dysfunction

Remember this as you strive to decide which dry eye questionnaires your optometry office should choose for patients.

Choosing the Right Questionnaire

Before selecting the questionnaires you would like to ask your optometry practice’s patients to fill out, make sure they’ll serve as the ideal assessments for those treated by your doctors. Consider everything from the length of these questionnaires to the factors they’ll take into account when assessing a patient’s eyes.

Most optometry practices can’t go wrong with the OSDI Questionnaire or SPEED assessments. However, if, for example, your clinical practice caters to quite a few women within your community, an option like the Women’s Health Study Questionnaire assists practices with diagnosing them. Other options could be better for contact lens wearers or aging patients.

Administration Methods

While considering which dry eye questionnaires to implement, consider how you’ll administer them. Do you want to send patients physical forms to fill out, or would you prefer for them to complete questionnaires digitally? Digital has become the best option for many practices since it allows them to keep more organized records.

Speaking of records, you’ll also need to incorporate questionnaires for dry eye symptoms into your patient intake process and keep the answers patients provide in their files. Optometrists will often refer back to the answers to see whether patients’ conditions improve over time.

Analyzing and Utilizing Results

Most dry eye questionnaires provide patients with test scores that indicate whether or not they might have dry eye and how severe their dry eye symptoms are. Optometrists must familiarize themselves with how to analyze and interpret scores. More importantly, they must decide how to proceed when assessments suggest patients have dry eye.

They can use the answers patients provide to perform additional anterior eye exams to determine the severity of their symptoms. From there, they can come up with dry eye treatment plans, including options like:

• Over-the-counter eye drops
• Prescription medications
• Tear duct plugs
• Daily life changes
• Surgeries

Benefits of Using an Eye Dryness Questionnaire

Sending out questionnaires to your optometry practice’s patients who believe they’ve been impacted by dry eye can offer good specificity and many benefits. Discover more about the advantages of using these assessments.

Enhanced Patient Communication

When you use dry eye questionnaires, the optometrists from your practice and your patients can communicate better than ever before. Optometrists can improve screening processes and determine how severe dry eye symptoms are and how frequently they affect patients to get to the bottom of problems quicker.

Your patients will appreciate your practice’s proactive approach to diagnosing dry eye. They’ll also like how much easier it is to explain the severity of their symptoms.

Improved Diagnostic Accuracy

Detecting dry eye early and beginning treatment is the key to preventing it from worsening. Dry eye questionnaires can help your practice treat patients with dry eye sooner and provide a way to achieve consistent and reliable diagnoses.

Streamlined Workflow

Diagnosing dry eye can take a lot of time when optometrists don’t use dry eye assessments. Investing in them can save time and make your practice more efficient overall.

Integrating Weave’s Solutions for Enhanced Patient Care

Using dry eye questionnaires is one way to enhance the care your optometry practice provides, but it isn’t the only option. Weave can also set up practice managers with other solutions to improve patient care.

Communication Tools

Weave offers an assortment of communication tools to help your practice when it comes to placing phone calls to patients, emailing patients, and even texting with patients in emergencies. You can also use them to send reminders about appointments and follow-ups to patients. It’ll deliver important information to them while complying with the necessary rules and regulations.

Online Scheduling and Digital Forms

Weave can enable your practice to further streamline your communication with patients through online scheduling and digital forms. You can also integrate dry eye questionnaires to give patients a better experience when filling one out.

Reviews and Email Marketing

Weave can help your clinical practice put patient feedback to good use with review management tools. The company can also help with educating patients and promoting eye care services through digital marketing.

Make Your Optometry Practice More Efficient by Using a Dry Eye Questionnaire

Picking the right dry eye questionnaire can make your optometry practice’s operation more seamless. Your optometrists and patients can both save time when you use dry eye assessments to your advantage.

Get a demo to see how Weave can transform your practice’s efficiency and patient care.