Comparison of Two Questionnaires for Dry Eye Symptom Assessment

The Ocular Surface Disease Index and the Symptom Assessment in Dry Eye


      The aim of this study was to compare patient-reported symptoms of dry eye disease (DED) as assessed by the Ocular Surface Disease Index (OSDI), a 12-item symptom frequency–based questionnaire, and the Symptom Assessment iN Dry Eye (SANDE), a 2-item frequency- and severity-based visual analog scale.


      Clinic-based evaluation of a diagnostic test.


      A total of 114 patients with DED.


      Patients were administered the OSDI and SANDE questionnaires at baseline and follow-up visits to evaluate DED-related symptoms. The correlations between both questionnaires' scores were evaluated using the Spearman coefficient, and their clinical differences were assessed using Bland–Altman analysis.

      Main Outcome Measures

      Baseline and follow-up visit OSDI and SANDE dry eye symptom scores.


      At the baseline visit, the OSDI and SANDE questionnaire scores were significantly correlated (R = 0.64; P < 0.001). Moreover, a significant correlation was found between changes in the OSDI and SANDE scores from baseline to follow-up visits (R = 0.47; P < 0.001). A Bland–Altman analysis, after score normalization, revealed a difference (bias) of less than 2 centesimal units between the scores of the 2 questionnaires.


      Data collected from the SANDE questionnaire showed a significant correlation and negligible score differences with those from the OSDI, suggesting that the SANDE visual analog scale–based questionnaire has the potential to provide clinicians with a short, quick, and reliable measure for DED symptoms.

      Abbreviations and Acronyms:

      CFS (corneal fluorescein staining), DED (dry eye disease), OSDI (Ocular Surface Disease Index), SANDE (Symptom Assessment iN Dry Eye)
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