RELATION BETWEEN SIGNS AND SYMPTOMS OF DRY EYE IN THE ELDERLY - A POPULATION-BASED PERSPECTIVE

Purpose: To examine the distribution and association of dry eye sympto ms, Schirmer test results, and rose bengal scores in a population-base d sample of elderly Americans. Design: Population-based prevalence sur vey. Participants: Involved were 2240 noninstitutionalized residents o f Salisbury, Maryland, aged 65 years and older as of September 1993, a nd identified by the Health Care Financing Administration Medicare dat abase. Main Outcome Measures: A standardized dry eye symptom questionn aire, rose bengal scoring of ocular surface staining, and Schirmer tes ts. Results: Fourteen percent of participants reported one or more sym ptoms 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 se en between lower Schirmer scores and presence of more frequent symptom s. Higher rose bengal scores were weakly associated with symptoms. The Schirmer and rose bengal test results, both individually and in combi nation, were insensitive in identifying individuals who had symptoms. Conclusions: Although symptoms of ocular irritation are common among t he elderly, these population-based data indicate that there is minimal overlap between individuals identified by questionnaire, Schirmer tes ts, and rose bengal scoring.