Speed Questionnaire Dry Eye
Glauco Schlembach
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This questionnaire was developed from a 51-item version of the NEI-VFQ. The 25-item questionnaire was developed to be a shorter version of the original that preserved its multidimensionality, reliability, and validity.[3] The questionnaire has several subscale categories that assesses different aspects of health-related quality of life including overall health, overall vision, difficulty with near vision, difficulty with distance vision, limitations in social functioning due to vision, role limitations due to vision, dependency on others due to vision, mental health symptoms due to vision, future expectations for vision, driving difficulties, and pain and discomfort around the eyes.[3] Due to its decreased number of items the shorter questionnaire takes 5 to 10 minutes while the longer questionnaire takes 15 minutes on average, making it easier to use in clinical settings and research.[3]
The SPEED questionnaire was designed by Korb and Blackie in order to quickly track the progression of dry eye symptoms over time.[9] This questionnaire gives a score from 0 to 28 that is the result of 8 items that assess frequency and severity of symptoms. The symptoms assessed include dryness, grittiness, scratchiness, irritation, burning, watering, soreness, and eye fatigue. The questionnaire further assesses whether these symptoms were not problematic, tolerable, uncomfortable, bothersome, or intolerable.[10] The questionnaire also monitored diurnal and symptoms changes over 3 months.[11] Validity of the questionnaire was determined by seeing how well it was able to segregate patients based on their symptoms, relative to the OSDI questionnaire (gold standard). The resulting sensitivity and specificity were 0.90 and 0.80 respectively.[11]
This survey was created by the Centre for Contact Lens Research of the University of Waterloo in order to obtain data on the severity and overall prevalence of dry eye symptoms in patients in Canada.[12] The survey was sent to optometric practices in all provinces of Canada, and contained 13 questions covering demographics, contact lens use, medications use, symptoms with and without contact lens usage, mouth dryness, swollen or red eyelids, severity of symptoms in the morning compared to the afternoon, and allergies.[13]
This questionnaire was created specifically for screening dry eye in patients in a proposed Dry Eye Epidemiologic Projects study.[14] The questionnaire consists of 19 questions, with only 14 being used in the analysis. The questions covered artificial tear or eye drop use, contact lens use, frequency of ocular symptoms, other types of dryness, and allergies. The sensitivity and specificity of this questionnaire are 0.6 and .94 respectively, based on irritation and dryness as predictor variables.[14] This suggests that this screening tool might be appropriate for dry eye patients in epidemiologic studies.
IDEEL is a 57-item questionnaire developed by Abetz et al., that that assess the impact of dry eye symptoms on everyday life.[20] This questionnaire consists of 3 modules: dry eye treatment satisfaction comprising of satisfaction with treatment effectiveness and treatment-related inconvenience/bother, dry eye impact on daily life comprising impact on daily activities, emotional impact, impact on work, and dry eye symptom-bother. This questionnaire assesses the impact of dry eye on quality of life, impact of treatment, and could aid in evaluating treatment effectiveness.[20] Concurrent validity between IDEEL dimensions and DEQ items expressed with Pearson coefficient correlations showed a range of -0.05-0.83.8 The correlations between the clinical findings and the treatment-related bother/inconvenience, symptom-related bother, impact on daily activities, emotional impact due to dry eye, and impact on work due to dry eye were low (p < 0.05).[20]
This questionnaire was developed by McCarty et al. and assesses dry eye disease in an older (over 40 years old) adult population in the city of Melbourne, Australia. The questionnaire ascertained discomfort, foreign body sensation, dryness, itching, tearing, and photophobia on a scale from 0 to 3.[21] If the patient had any of these symptoms they were asked if they thought it was related to hay fever. A history of dry mouth was also obtained and graded on a scale of 0 to 3.[21] The results of this questionnaire were used in an epidemiology study in order to determine the incidence of dry eye in Australia.
This questionnaire was developed by McMonnies et al. to screen for possible dry eye symptoms and to assess risk factors.[13] This instrument has 14 questions that focus on risk factors of dry eye. These risk factors include gender, age, contact lens history, dry eye symptoms, secondary symptoms, medical conditions associated with dry eye syndrome, dryness of mucous membranes, medication use, and previous dry eye treatments.[22] This questionnaire helps detect dry eye disease, as well as patients at risk for developing dry eye disease due to exposure to specific factors that the instrument indicates.[22] Concurrent validity was fair when compared to the NEI-VFQ25, with a statistically significant correlation with the pain module (r = -0.28 [p = 0.02]).[22]
The OCI questionnaire was developed by Johnson and Murphy as an instrument that allows for quick assessment of ocular comfort. It has 15 items that were identified from interviews of patients and a literature review. Eight areas were identified: positive (comfort), and negative (visual stability, tiredness, stinging, pain, itching, grittiness, and dryness).[24] Subparts were extrapolated from these areas and quantified with frequency and intensity. The OCI is able to detect symptom improvement before and after lubricant treatment (95% confidence interval of the treatment difference was -5.5 to -8.0 [P < 0.0001]).[24] The validity of the questionnaire showed a sensitivity 0.567 and a specificity of 0.550 in patients that have contact lens induced dry eye.[25]
Developed by Schein et al. this questionnaire was used for an epidemiologic study to examine the distribution of dry eye in a population of Salisbury, Maryland older than 65 years old.[28] The questionnaire consisted of questions relating to six symptoms and their frequency. The questionnaire results were not well validated, with little correlation between the symptom score of the questionnaire and different clinical tests such as Schirmer test, Rose Bengal stain, as well as sociodemographic characteristics such as race, age, and sex.[29]
This questionnaire was developed by the Texas Eye Research and Technology Center in order to identify moderate dry eye symptoms in patients that do not wear contact lenses.[30] The questionnaire has 28 items that were developed from the Dry Eye Questionnaire, that include symptoms, demographics, medications, and effect on daily living. Patients with a score above 32.3 had moderate dry eye while those below the threshold were considered healthy patients (sensitivity = 0.75 and specificity = 1.00).[13] Moderate concurrent validity with McMonnies (Spearman correlation coefficient = 0.507 [P = 0.003]) was shown.[13][30]
This questionnaire was developed by Schaumberg et al. to describe the magnitude of dry eye syndrome among women in the U.S.[31] This tool is easy to use in epidemiologic studies as well as for clinical research.[32] There are only 3 items in the questionnaire that are used to gauge the frequency of dryness, and symptoms of irritation as well as past history of dry eye syndrome that was diagnosed clinically.[31] The sensitivity and specificity of the questionnaire are 0.77 and 0.83 respectively when compared to clinical confirmation of dry eye syndrome.[32]
Dr. Sara N. Frye is an optometrist with over 13 years of experience in both academia and private practice. She currently works as a clinical project lead in Clinical Development & Medical Affairs at Alcon. Her area of focus is monofocal and toric IOLs and injectors.
According to a 2018 study, SPEED is a valid instrument for measuring symptoms of dry eye. The authors concluded that the questionnaire was repeatable and the results correlated to findings of other objective diagnostic tests.
The Ocular Surface Disease Index (OSDI) is another questionnaire that eye care professionals commonly use to evaluate dry eye symptoms. While both OSDI and SPEED aim to assess the frequency of dry eye symptoms using a self-reported grading scale, there are some differences between the two questionnaires, including the following:
Purpose: This study reports on the ability of the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire to detect dry eye (DE) symptoms in contact lens (CL) and non-CL wearers.
Methods: The SPEED questionnaire was administered to all subjects while the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) was only administered to CL wearers. Tear meniscus heights (TMH) were measured, and the phenol red thread (PRT) test was conducted. These tests along with self-reported DE were used to identify subjects with dry eye disease (DED). Rasch analysis was performed to evaluate the questionnaires for measurement precision and unidimensionality, and the scores from these Rasch analyses were used to understand their ability to predict measures of DED.
Results: We enrolled 284 subjects (150 CL and 134 non-CL wearers). Mean subject age was 39.4 14.2 years. Rasch analysis yielded a multidimensional short form of the SPEED questionnaire (8-items) and a unidimensional short form of the CLDEQ-8 (4-item). Scores from both questionnaires were significantly associated with self-reported DE in CL and non-CL wearers. Scores of the 8-item SPEED questionnaire were associated with DED status in non-CL wearers but not in CL wearers while 4-item CLDEQ scores were associated with DED status in CL wearers. TMH or PRT were not associated with either questionnaire in CL or non-CL wearers.
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