# Comparison of patient reported dry eye symptoms as evaluated by the ocular surface disease index and symptom assessment

**Authors:** Solani D. Mathebula, Percy R. Khosa, Mmathabo M. Maleswene

PMC · DOI: 10.4102/phcfm.v17i1.4861 · African Journal of Primary Health Care & Family Medicine · 2025-05-21

## TL;DR

This study compares two questionnaires for assessing dry eye symptoms and finds they are highly correlated, suggesting both are effective.

## Contribution

The study demonstrates that the SANDE questionnaire is a valid and efficient alternative to the OSDI for assessing dry eye symptoms.

## Key findings

- OSDI and SANDE scores were highly correlated (Spearman correlation of 0.7).
- The mean difference between the two questionnaires was negligible (−0.97).
- Bland–Altman analysis showed minimal bias between the two questionnaires.

## Abstract

Dry eye disease (DED) is a growing public health problem because of excessive time spent on digital devices as a risk factor. The diagnosis of DED should not only be based on the objective clinical measures but also on symptoms reported by patients. Clinicians should not rely on establishing symptoms using open verbal questioning during the case history but should quantify patient symptoms using a validated questionnaire.

To compare the patient-reported symptoms of DED as assessed using the Ocular Surface Disease Index (OSDI) and Symptom Assessment in Dry Eye (SANDE).

An optometry clinic.

Ocular Surface Disease Index and SANDE questionnaires were administered to 40 participants. Participants completed all questionnaires in a non-randomised order. The correlation between the questionnaires’ scores was determined and the Bland–Altman plot was used to assess the agreement between the two questionnaires.

The mean scores for OSDI and SANDE were 37.85 ± 23.79 and 38.83 ± 26.39, respectively. The Spearman correlation between the two questionnaires was 0.7, p < 0.01. The mean difference between OSDI and SANDE was −0.97 (95% Confidence Interval [CI]: [−7.04 to 5.09]). The Bland–Altman analysis between OSDI and SANDE showed a mean clinical difference (bias) of –0.98.

The SANDE questionnaire can be used as a dry eye symptom assessment as it is highly correlated to the OSDI questionnaire.

Because the OSDI and SANDE questionnaires showed a significant correlation and negligible score differences, this suggests that the SANDE questionnaire has the potential to provide clinicians with a short and quick measure of DED symptoms.

## Full-text entities

- **Diseases:** Ocular Surface Disease (MESH:D010534), dry eye symptoms (MESH:D015352)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12135706/full.md

## References

38 references — full list in the complete paper: https://tomesphere.com/paper/PMC12135706/full.md

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Source: https://tomesphere.com/paper/PMC12135706