Woodward Maria A, Valikodath Nita G, Newman-Casey Paula Anne, Niziol Leslie M, Musch David C, Lee Paul P
Department of Ophthalmology and Visual Sciences (M.A.W., N.G.V., P.A.N.-C., L.M.N., D.C.M., P.P.L.), University of Michigan Medical School, Ann Arbor, MI; Institute for Healthcare Policy and Innovation (M.A.W., P.A.N.-C., D.C.M., P.P.L.), University of Michigan, Ann Arbor, MI; and Department of Epidemiology (D.C.M.), University of Michigan School of Public Health, Ann Arbor, MI.
Eye Contact Lens. 2018 Nov;44(6):384-389. doi: 10.1097/ICL.0000000000000403.
Ophthalmologists assess eye complaints with a careful history and eye examination; however, other types of physicians have limited tools to evaluate anterior segment (AS) eye diseases. We identified the eye symptom questions that providers should ask to help determine the presence and urgency of AS eye diseases.
Persons with and without AS disease completed a self-report eye symptom questionnaire (ESQ) based on the National Institutes of Health Toolbox symptom items in an academic center's corneal and comprehensive eye clinics. Gold standard ophthalmic examination determined the presence and urgency of AS disease. The association between reported symptom severity and the probability of AS disease, or urgent AS disease, was evaluated using logistic regression models, and sensitivity and specificity of the ESQ were also calculated.
A total of 324 eyes of 162 subjects were included in the study. Of these, AS disease was present in 255 eyes (79%); of which, 111 eyes showed urgent disease. Increasing symptom severity for eye pain (odds ratio [OR]=2.58; P<0.001), glare (OR=2.61; P=0.001), and blurry vision (OR=1.98; P<0.001) were associated with increased odds of AS disease. Increasing symptom severity for eye pain (OR=2.02; P<0.001), eye redness (OR=1.69; P=0.02), and blurry vision (OR=1.41, P=0.01) were associated with increased odds of urgent AS disease. For the primary analysis with mild symptoms considered relevant, the sensitivity of the ESQ to detect AS disease was 83% and to detect urgent AS disease was 92%.
Symptoms of eye pain, glare, redness, and blurry vision indicate the presence and urgency of AS disease.
眼科医生通过详细的病史询问和眼部检查来评估眼部不适；然而，其他类型的医生评估眼前段（AS）眼病的工具有限。我们确定了医生应询问的眼部症状问题，以帮助判断AS眼病的存在及紧急程度。
在一个学术中心的角膜和综合眼科诊所，患有和未患有AS疾病的人根据美国国立卫生研究院工具箱症状项目完成了一份自我报告眼部症状问卷（ESQ）。金标准眼科检查确定了AS疾病的存在及紧急程度。使用逻辑回归模型评估报告的症状严重程度与AS疾病或紧急AS疾病概率之间的关联，并计算了ESQ的敏感性和特异性。
该研究共纳入了162名受试者的324只眼睛。其中，255只眼睛（79%）存在AS疾病；其中，111只眼睛显示为紧急疾病。眼痛（优势比[OR]=2.58；P<0.001）、眩光（OR=2.61；P=0.001）和视力模糊（OR=1.98；P<0.001）症状严重程度的增加与AS疾病几率的增加相关。眼痛（OR=2.02；P<0.001）、眼红（OR=1.69；P=0.02）和视力模糊（OR=1.41，P=0.01）症状严重程度的增加与紧急AS疾病几率的增加相关。对于将轻度症状视为相关因素的初步分析，ESQ检测AS疾病的敏感性为83%，检测紧急AS疾病的敏感性为92%。
眼痛、眩光、眼红和视力模糊症状表明AS疾病的存在及紧急程度。
