The relative burden of dry eye in patients' lives: Comparisons to a US normative sample

PURPOSE. To assess the relative burden of dry eye in daily life by comparing Short Form-36 (SF-36) responses from individuals with and without dry eye against U. S. norms. METHODS. Assessment of 210 people, 130 with non-Sjogren's keratoconjunctivitis sicca (non-SS KCS), 32 with Sjogren's Syndrome ( SS), and 48 control subjects. The study population data and published normative SF-36 data were compared. Dry eye severity was assessed by recruited severity ( control, non-SS KCS, SS), patient self-report ( none, very mild/mild, moderate, severe/extremely severe), and clinician-report ( none, mild, moderate, severe). Age- and gender-matched norms were compared with all defined severity groups. RESULTS. Compared with the norms, control subjects scored higher on all SF-36 scales. Effect size (ES) ranged from 0.15 to 0.52. Non-SS KCS patients had lower Role-Physical (ES = - 0.07), Bodily Pain (ES = - 0.08), and Vitality (ES = - 0.11) scores, indicating more dry eye impact on those areas versus the norm. All SF-36 scale scores except Mental Health (ES = 0.12) were lower in the SS group than the adjusted norm ( ES range: - 0.16 to - 0.99). Regardless of severity classification, mild patients consistently had lower Role-Physical and Bodily Pain scores than the norm, suggesting impact on daily roles ( ES < 0.2). Patients with moderately severe disease also experienced less vitality and poorer general health. The group with severe disease scored lower than the norm across all domains (ES range: - 0.14 to - 0.91) except Role- Emotional (ES = 0.13) and Mental Health (ES = 0.23). CONCLUSIONS. These results indicate dry eye's negative impact on everyday life, particularly in daily activities. Further research using disease-specific measures to examine dry eye's impact is underway.