当前临床实践中对干眼疾病管理的认知。

Perceptions of dry eye disease management in current clinical practice.

机构信息

University of North Carolina School of Medicine (J.F.W.), Chapel Hill, NC; Department of Internal Medicine (J.F.W.), New Hanover Regional Medical Center, Wilmington, NC; George Washington University School of Medicine (K.H.), Washington, DC; Doris Duke Clinical Research Fellow (K.H.), University of North Carolina, Chapel Hill, NC; Department of Medicine (M.A.W.), Division of General Medicine and Epidemiology, University of North Carolina, Chapel Hill, NC; and Department of Ophthalmology (R.M.D.), University of North Carolina, Chapel Hill, NC.

出版信息

Eye Contact Lens. 2014 Mar;40(2):111-5. doi: 10.1097/ICL.0000000000000020.

DOI:10.1097/ICL.0000000000000020

PMID:24508770

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4440861/

Abstract

OBJECTIVE

To assess the perceptions of eye care providers regarding the clinical management of dry eye.

METHODS

Invitations to complete a 17-question online survey were mailed to 400 members of the North Carolina Ophthalmology and Optometry Associations including community optometrists, comprehensive ophthalmologists, and cornea specialists.

RESULTS

The survey was completed by 100 eye care providers (25% response rate). Providers reported burning (46.5%) as the most frequent symptom described by patients, followed by foreign body sensation (30.3%) and tearing (17.2%). Most respondents (80.8%) listed artificial tears as the recommended first-line treatment, even though providers reported high failure rates for both artificial tears and cyclosporine A (Restasis). Rheumatoid arthritis, Sjögren syndrome, affective disorders such as anxiety and depression, history of photorefractive surgery, smoking, and thyroid disease were acknowledged as common comorbid conditions.

CONCLUSIONS

The survey provided an informative snapshot into the preferences of eye care providers concerning the diagnosis and management of dry eye disease. Overall, burning was the most common symptom reported by patients. Providers relied more on patient history in guiding their clinical decisions than objective signs. The survey underscores the incongruence when comparing subjective symptoms with objective signs, thereby highlighting the urgent need for the development of reliable metrics to better quantify dry eye symptoms and also the development of a more sensitive and specific test that can be used as the gold standard to diagnose dry eye.

摘要

目的

评估眼科护理提供者对干眼临床管理的认知。

方法

向北卡罗来纳州眼科和验光协会的 400 名成员（包括社区验光师、综合眼科医生和角膜专家）邮寄了一份包含 17 个问题的在线调查邀请。

结果

该调查由 100 名眼科护理提供者完成（回应率为 25%）。提供者报告说，患者最常描述的症状是烧灼感（46.5%），其次是异物感（30.3%）和流泪（17.2%）。大多数受访者（80.8%）将人工泪液列为推荐的一线治疗方法，尽管提供者报告人工泪液和环孢素 A（Restasis）的失败率都很高。类风湿关节炎、干燥综合征、焦虑和抑郁等情感障碍、光折射手术史、吸烟和甲状腺疾病被认为是常见的合并症。

结论

该调查提供了一个有关眼科护理提供者对干眼诊断和管理偏好的信息快照。总体而言，烧灼感是患者报告的最常见症状。提供者在指导临床决策时更多地依赖于患者的病史，而不是客观迹象。该调查突显出主观症状与客观迹象之间的不一致性，从而强调迫切需要开发可靠的指标来更好地量化干眼症状，并开发更敏感和特异的测试作为诊断干眼的金标准。