Dry Eye Symptomatology of Soft Contact Lens Wearers and Nonwearers

Purpose. This study attempted to identify the questions most suitable to detect dry eye in a contact lens-wearing and noncontact lens-wearing population to optimize history-taking in routine practice. Methods. The McMonnies questionnaire was applied to both soft contact lens wearers and nonwearers attending the clinic for routine screening. The test population in this retrospective analysis was made up of 502 daily soft contact lens wearers (SCLW) and 309 noncontact lens wearers (NCLW). The diagnostic value of individual questions was determined by CHAID analysis. Results. Forty-three percent of soft contact lens wearers were identified as symptomatic, of whom 28% had moderate to severe symptoms. In comparison, 15% of age-matched noncontact lens wearers were symptomatic, 5% at moderate or severe level. The question on frequency of dryness had the highest diagnostic value. Of those who had "never" experienced dryness, 87% of SCLW and 95% of NCLW were judged normal as per the questionnaire; this increased to 94% and 99%, respectively, if they also "never" experienced scratchiness (SCLW) and "never" experienced burning (NCLW). In SCLW, if dryness was experienced often, the subjects were found to be symptomatic in 90% of cases. This figure rose to 96% if the response yes was given to "sensitivity to smoke." Systemic associations were found to be more relevant to NCLW. Conclusions. The most predictive question for the detection of dry eye was frequency of ocular dryness. Scratchiness, burning symptoms, and sensitivity to cigarette smoke and to make-up products were additional indicators.