Development and validation of a short global dry eye symptom index

Ocul Surf. 2007 Jan;5(1):50-7. doi: 10.1016/s1542-0124(12)70053-8.


ABSTRACT we have developed and evaluated the repeatability of a short questionnaire based on a visual analog scale (VAS) to quantify the frequency and severity of symptoms of dry eye syndrome (DES). The "Symptom Assessment iN Dry Eye" (SANDE) questionnaire utilizes a 100 mm horizontal VAS technique to quantify patient symptoms of ocular dryness and/or irritation. Fifty-two subjects with DES were prospectively enrolled and followed-up at 2 and 4 months with repeated administrations of the SANDE questionnaire and clinical ocular surface evaluation. Subjects demonstrated a wide range of symptom scores indicative of the variability of the disease. Analyses comparing the repeatability of SANDE scores from baseline to the 2-month follow-up indicated a significant downward regression of scores toward the mean. In contrast, repeatability measures were consistently good for questionnaires administered within a few days of one another (ICC ranging from 0.53 to 0.76). Bland-Altman analysis demonstrated that 50% of repeated SANDE symptom scores were within 10 mm of each other, 80% were within 20 mm, and 95% were within less than 30 mm. These data describe good repeatability for the SANDE symptom score when repeated assessments are made within a few days. The results are encouraging and suggest that further refinement and testing of the SANDE questionnaire in larger populations may result in a reliable questionnaire to detect change in irritative symptoms over time.

Publication types

  • Multicenter Study
  • Validation Study

MeSH terms

  • Aged
  • Disease Progression
  • Dry Eye Syndromes / complications
  • Dry Eye Syndromes / diagnosis*
  • Dry Eye Syndromes / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pain / diagnosis*
  • Pain / epidemiology
  • Pain / etiology
  • Pain Measurement
  • Prevalence
  • Prospective Studies
  • Severity of Illness Index
  • Surveys and Questionnaires
  • United States