Associations of the Severity of Dry Eye Symptoms and Signs with Quality of Life in the Dry Eye Assessment and Management (DREAM) Study.

To assess associations of the severity of the symptoms and signs of dry eye disease (DED) with the quality of life in patients with moderate-to-severe DED. At baseline, 6 and 12 months, participants (n = 535) were assessed for DED symptoms using the Ocular Surface Disease Index (OSDI) and signs using conjunctival staining, corneal staining, tear break-up time (TBUT), Schirmer's testing, meibomian gland dysfunction, and tear osmolarity. Quality of life was evaluated using the Short Form Health Survey (SF-36), consisting of a Physical Component Summary (PCS) and Mental Component Summary (MCS). Spearman correlation coefficients (rho) were used to evaluate correlations between the severity of DED and the SF-36. At baseline, worse DED symptoms indicated by a higher OSDI total score were correlated with worse PCS (rho = -0.13, = 0.002) and MCS (rho = -0.09, = 0.03) in the SF-36. Worse vision-related function was correlated with a worse PCS score (rho = -0.18, < 0.0001), and worse ocular symptoms were correlated with a worse MCS score (rho = -0.15, < 0.001). More severe DED signs including corneal staining (rho = -0.22, < 0.001), Schirmer test (rho = 0.11, = 0.01), TBUT (rho = 0.14, < 0.001), and tear osmolarity (rho = -0.12, = 0.02) were correlated with a worse PCS score but were not correlated with MCS score ( ≥ 0.39). ln longitudinal analysis, only the worsening of ocular symptoms was significantly correlated with the worsening of the MCS score (rho = -0.09, = 0.04). In patients with moderate-to-severe DED, there were significant yet weak correlations between the severity of dry eye symptoms/signs and the physical or mental components of the SF-36. Healthcare professionals should offer patients with DED symptom relief and support for the emotional and practical challenges in their daily lives.