A survey of just over 200 optometrists and ophthalmologists has revealed that practitioners appear to prioritise patient-reported symptoms over clinical signs in making dry eye disease (DED) treatment decisions.
The survey, presented at the recent ARVO conference in Denver, was completed by 98 ophthalmologists and optometrists.
They provided information about the demographics of their patients and also indicated which factors influence treatment initiation, how they manage sign-symptom discordance and how they define treatment success.
The practitioners said they used both clinical signs and symptoms during the DED treatment process. But they revealed that symptoms had a more significant influence on decisions.
Because of that, they were more likely to treat patients with even moderate-severe symptoms even when objective signs were minimal.
Dr Kaleb Abbott, a lead survey author from the University of Colorado School of Medicine, said: “One of the most surprising findings was just how strongly clinicians prioritised symptoms over signs in dry eye management.”
“Providers were overwhelmingly willing to initiate treatment even when clinical signs were minimal or absent, as long as patients reported significant symptoms.
“Likewise, many clinicians still considered treatment successful if symptoms improved despite no objective improvement in ocular surface findings.”
He said that suggested that “in real-world practice, patient experience often drives management decisions more than traditional diagnostic metrics”.
The survey showed that “ophthalmologists appeared to weigh symptoms even more strongly when defining treatment success”, he said.
“Optometrists still favoured symptoms overall, but placed slightly greater emphasis on objective signs compared to ophthalmologists, particularly when evaluating outcomes.”
