S.P. Mahesh MD Janine Clayton MD Nida H Sen MD

1. Vision related quality of life in persons with Dry eye syndrome using the 25 item National eye Institute visual function questionnaire S.P. Mahesh MD Janine Clayton MD NidaH Sen MD

2. Abstract Purpose: To evaluate the vision related quality of life in patients with Dry eye syndrome using the National eye institute Visual function Questionnaire (NEI VFQ-25) Methods: Data from patients with Dry eye syndrome, Uveitisretrieved from NEI database Visual function questionnaire used to assess the impact of the disease process on the quality of life data Results: • Dry eyes (n=22), were compared with Uveitis (n=48) and reference control (n=22) were identified. • Mean subscale scores were lower in patients with dry eyes and uveitisas compared with controls • Subscale analysis showed that mean responses were lower in terms of general health, general vision, near vision, distance vision, driving, peripheral vision and social functioning as compared to controls. • Distance vision and driving were the most significantly affected in dry eye patients compared to controls. Conclusion: • Patients with dry eye syndrome have poorer vision related quality of life. • Apart from the severity of the disease symptoms, assessing quality of life helps in understanding the impact of the disease process and the treatment effect.

3. Background • Ocular surface disorders can result in impairment of vision related quality of life • Apart from Visual acuity, other aspects of visual function can result in vision related disability • NEI VFQ-25 questionnaire is an instrument designed to evaluated the vision related quality of life and to test psychometric properties of diseases that cause vision loss

4. Purpose • To evaluate the vision related quality of life in patients with Dry eye syndrome using the National eye institute Visual function Questionnaire (NEI VFQ-25) and to compare with normal and disease controls

5. Materials and Methods • Visual function questionnaire were retrieved from patients with dry eye syndrome and uveitis from a database at NEI. • NEI VFQ-25 addresses 12 subscales: General health, Near vision, Distnace vision, Driving, Peripheral vision, Color vision, Ocular pain, Role limitation, Dependency, Social functioning, Mental health

6. Materials and Methods • Scores of VFQ-25 were converted to scaled scores as per scoring algorithm • Subscale scores were also compared with previously published reference controls.

7. Results • Mean subscale scores: • lower in patients with dry eye syndrome and uveitisas compared with published reference controls. • No differences between dry eye syndrome and uveitis patients • In patients with both dry eye syndrome and uveitis, • mean responses were significantly lower in terms of general vision, near vision, distance vision, driving, peripheral vision, role difficulty, dependency, mental health and social functioning as compared to controls (p <0.05). • Distance vision and driving were the most significantly affected in dry eye patients compared to controls.

8. Results

9. Discussion • Patients with Dry eye syndrome experience subjective negative impact in vision related quality of life. • Compared with reference controls the subjective impact was significant in most of the categories except color vision and peripheral vision • Compared to other vision threatening diseases like uveitis, it had similar impact in vision related quality of life

10. Conclusions • Patients with dry eye syndrome have significantly lower vision related quality of life comparable to sight threatening diseases like uveitis. • Assessing vision releated quality of life can determine the impact of disease process and treatment effects