PURPOSE: The Dry Eye Questionnaire 5 (DEQ-5) was developed by streamlining the habitual symptoms in the Dry Eye Questionnaire (DEQ) to discriminate between groups with varying self-assessed severity of dry eye (DE). As further validation, we now test the ability of the DEQ-5 to discriminate DE populations of various etiologies and asymptomatic controls.
METHODS: 260 subjects in 2 DE studies conducted in 2002 and 2005 completed the DEQ. The sample included 48 asymptomatic controls (C) and 212 subjects diagnosed as DE; 57 with Sjögren Syndrome (SS) by the American-European criterion of 2002, and 155 with practitioner diagnosed non-SS DE. The DEQ-5 is comprised of 5 items: frequency of watery eyes, discomfort, and dryness (0-4 scale) and late day discomfort and dryness intensity (0-5 scale). Differences across groups were analyzed by Kruskal-Wallis test and by Chi-square between groups.
RESULTS: Average DEQ-5 score for C subjects was 2.7 (SD 2.9, 95% C.I., 1.8, 3.5), for non-SS DE subjects 10.5 (SD 4.5, 95% C.I. 9.8, 11.1) and for SS subjects 14.0 (SD 3.4, 95% C.I. 13.1, 14.9). Scores differed significantly for the population overall (Z=-8.6, p=0.000) and between each group (X2 = 116.3, p =0.000). Watery eyes were reported primarily by non-SS DE subjects. Proposed criteria for the DEQ-5 are > 6 for suspicion of non-SS DE and >12 for SS DE.
CONCLUSIONS: The short DEQ-5, the sum of scores for frequency and late day intensity of dryness and discomfort plus frequency of watery eyes, was very efficient at discriminating between normals and DE subjects and between the DE subject types. At this preliminary stage, cutoffs for the DEQ-5 scores > 6 indicate DE and >12 indicate further testing to rule out SS DE. Future research will test if symptoms captured in the DEQ-5 respond to effective treatment.