Relation between signs and symptoms of dry eye in the elderly. A population-based perspective

Ophthalmology. 1997 Sep;104(9):1395-401. doi: 10.1016/s0161-6420(97)30125-0.


Purpose: To examine the distribution and association of dry eye symptoms, Schirmer test results, and rose bengal scores in a population-based sample of elderly Americans.

Design: Population-based prevalence survey.

Participants: Involved were 2240 noninstitutionalized residents of Salisbury, Maryland, aged 65 years and older as of September 1993, and identified by the Health Care Financing Administration Medicare database.

Main outcome measures: A standardized dry eye symptom questionnaire, rose bengal scoring of ocular surface staining, and Schirmer tests.

Results: Fourteen percent of participants reported one or more symptoms to be present often or all the time. The mean Schirmer score in the lower testing eye was 12.4 and 42% had a rose bengal score of 1 or greater. No significant differences by age, gender, or race were seen for symptoms, Schirmer, or rose bengal testing. No association was seen between lower Schirmer scores and presence of more frequent symptoms. Higher rose bengal scores were weakly associated with symptoms. The Schirmer and rose bengal test results, both individually and in combination, were insensitive in identifying individuals who had symptoms.

Conclusions: Although symptoms of ocular irritation are common among the elderly, these population-based data indicate that there is minimal overlap between individuals identified by questionnaire, Schirmer tests, and rose bengal scoring.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dry Eye Syndromes / diagnosis*
  • Dry Eye Syndromes / epidemiology
  • Dry Eye Syndromes / physiopathology
  • Female
  • Fluorescent Dyes
  • Humans
  • Male
  • Maryland / epidemiology
  • Population Surveillance
  • Prevalence
  • Rose Bengal
  • Surveys and Questionnaires
  • Tears / physiology


  • Fluorescent Dyes
  • Rose Bengal