To compare the Standard Patient Evaluation of Eye Dryness (SPEED) and the Ocular Surface Disease Index (OSDI) questionnaires, and to further validate the SPEED questionnaire using the OSDI in a nonclinical sample. This was a cross-sectional study involving 657 undergraduate students aged 18-34 years. Subject selection was by systematic random methods. The Cronbach alphas of the SPEED and OSDI questionnaires were 0.895 and 0.897, respectively. Classification of participants based on OSDI grading of severity indicated that the total mean SPEED score were 2.2, 5.0, 6.6 and 9.9 for the asymptomatic, mild, moderate and severe dry eye groups respectively (F(3,653) = 141.3 P < 0.001,η=0.394). Post hoc testing for all between-group differences was statistically significant (P < 0.05; Tukey test of multiple comparisons). There was a significant correlation between the total scores of the OSDI and SPEED questionnaires (rs = 0.68 P < 0.001). The receiver operating characteristic curve (ROC) of the SPEED questionnaire was plotted, and the area under the curve (AUC) was estimated to be 0.82 (95% CL: 0.79-0.85; P < 0.001). Factor analysis revealed 3 dimensions as responsible for the substantial amount of variance in the data generated by the SPEED questionnaire. The SPEED questionnaire was good in separating asymptomatic and symptomatic participants in comparison with the OSDI. This indicates that the SPEED questionnaire is a valid measure for dry eye symptoms even in a nonclinical sample and would be useful in epidemiological studies and clinical practice for dry eye symptom assessment.

Background: To estimate the prevalence and risk factors of symptomatic dry eye disease (DED) among undergraduate students in a Ghanaian university. Methods: This cross-sectional study included 700 undergraduate students of the University of Cape Coast, aged 18 to 34 years. Participants completed questionnaires delivered directly to randomly and systematically selected subjects to detect symptomatic dry eye and its predictive factors. Symptomatic dry eye was defined as any reported symptom on the Standard Patient Evaluation Eye Dryness (SPEED) questionnaire reported as often or constant or if any symptom on the Ocular Surface Disease Index (OSDI) was reported as most of the time or all of the time. Furthermore, OSDI ≥13 and SPEED ≥6 were used to defined symptomatic dry eye and prevalence were also estimated with these criteria as secondary measures. Current symptoms of dry eye and possible risk factors such as age, gender, current alcohol drinking, use of oral contraceptives, use of computer more than an hour daily, environmental conditions, allergies, and self-medication with over-the-counter eye drops were the main outcome measures. We used logistic regression analysis to examine the associations between dry eye and its predictive factors. Results: Of the 700 participants, 650 completed the questionnaire. The prevalence of symptomatic dry eye was 44.3% (95% confidence interval [CI], 40.6%–48.2%). There was a significant association between symptomatic dry eye and discomfort with eyes in windy conditions (χ²=110.1; df=4; P<0.001), areas with low humidity (χ²=91.6; df=4; P<0.001), and air-conditioned rooms (χ²=89.0; df=4; P<0.001). Self-medication with over-the-counter eye drops (OR 4.20; 95% CI, 2.61–6.74; P<0.001), any allergies (OR 2.46; 95% CI, 1.42–4.29; P=0.001), and use of oral contraceptives (OR 4.04; 95% CI, 1.02–16.01; P=0.047) were predictive factors of symptomatic dry eye. Sex was predictive in univariate analysis but was not significantly associated in multivariate analysis. Conclusions: The prevalence of symptomatic dry eye among undergraduate students in Ghana is high and it is associated with self-medication with over-the-counter eye drops, allergies, use of oral contraceptive, windy conditions, very low humid areas, air-conditioned rooms, and sex. Relevant input directed against modifiable risks factors may have a positive impact on the well-being of undergraduate students in Ghana.

To evaluate the association between subjective dry eye symptoms and the results of the clinical examinations. The study was a clinical-based survey involving 215 first-year students selected consecutively during a regular ocular health examination at the University of Cape Coast Optometry Clinic. The data collection process spanned for a period of four months. Out of the 215 students, 212 returned their completed questionnaires and were subsequently included in the study. Dry eye tests including meibomian gland assessment, tear break up time, fluorescein staining, Schirmer test, and blink rate assessment, were performed on each subject after completion of the Ocular Surface Disease Index (OSDI) questionnaire. Shapiro-Wilk test was used to determine the normality of the clinical tests, and Spearman's correlations co-efficient was used to determine the correlations between the clinical test results and dry eye symptoms. Statistically significant associations were found between OSDI scores and blink rate (rs = 0.140; P < 0.042), and associations between OSDI scores and contrast sensitivity scores (rs = 0.263; P < 0001). However, the results of corneal staining (rs = -0.006; P < 0.926), Schirmer test (rs = -0.033; P = 0.628), tear break up time (rs = -0.121; P < 0.078), meibomian gland expressibility (rs = 0.093; P < 0.180), and meibomian gland quality (rs = 0.080; P < 0.244) showed no significant association with OSDI. The correlation coefficients range from -0.006 to 0.263 showed low to moderate correlation between dry eye symptoms and the results of clinical test. Associations between dry eye symptoms and clinical examinations are low and inconsistent, which may have implications for the diagnoses and treatment of dry eye disease.

Objective: To determine the impact of dry eye on quality of life, depression, anxiety, and stress in a healthy youthful clinical sample. Methods: This was a clinic-based cross-sectional study. Subjects were patients visiting the University of Cape Coast Eye Clinic for comprehensive eye examination. The age range for recruitment into the study was 16 to 35 years. Eligible participants completed three questionnaires namely the Ocular Surface Disease Index (OSDI), short version of the depression, anxiety, and stress scale (DASS-21), dry eye quality of life score (DEQS) questionnaire. All eligible participants underwent clinical assessment including meibomian gland expressibility, corneal staining, tear breakup time, and Schirmer 1 test. The Spearman correlation coefficient was used to determine the relationship between variables. Univariate and multivariate analyses of variance were used to determine the impact of the OSDI score on DASS-21 subscales scores and the dry eye quality of life scores. Results: All 211 subjects who met the inclusion criteria were included in the analysis. The mean age for the entire sample was 21.6±3.0 years with a range of (17–31) years. Spearman correlation coefficient showed a statistically significant association between OSDI scores and DEQSs (P<0.001), anxiety scores (P<0.001), depression scores (P<0.001), and stress scores (P0.05), DASS-21 subscales scores (P>0.05), except anxiety subscale and meibomian gland expressibility score (P=0.026). There were no statistically significant association between clinical test results and OSDI scores (P>0.05) except for the tear breakup time (P=0.018). Using Pillai's trace in the multivariate analysis of variance (MANOVA), there was a significant effect of OSDI severity classification on depression, anxiety, and stress subscales scores of the DASS-21, V=0.37, F_{(3, 207)}=9.67, P<0.001. Furthermore, separate univariate analyses of variances on the outcome variables revealed a significant effect of OSDI severity classification on depression F_{(3, 207)}=35.24, P<0.001, anxiety F_{(3, 207)}=25.27, P<0.001, and stress F_{(3, 207)}=13.08, P<0.001. The MANOVA was followed up with a discriminant analysis, which revealed three discriminant functions. When subjects were classified according to the OSDI grading of severity, there were a statistically significant difference between all levels of severity dry eye symptoms for the DEQSs (F_{(3, 207)} = 63.9.3 P<0.001, η²=0.48). Conclusion: The study showed that the severity of dry eye symptoms impacted on psychosomatic symptoms and quality of life. The study also revealed that the severity of dry eye symptoms impacted more on the depressive symptoms compared with other psychosomatic symptoms in this youthful clinical sample.

Purpose. To determine normative values of retinal nerve fibre layer thickness (RNFL) and optic nerve head (ONH) parameters and their association with routine clinical tests such as refractive error (RE), stereoacuity (SA), and contrast sensitivity (CS) in an African population. Methods. In a cross-sectional observational study, 100 normal subjects aged 20 to 78 years were evaluated using the Cirrus HD-OCT 5000 and matched with 200 glaucoma patients. Results. Average (±SD) RNFL thickness for normal subjects was found to be 102.37 ± 7.45 (range, 82–119 microns) compared with 90.74 ± 14.50 found for glaucoma subjects. Females had higher average RNFL values (104.84 ± 6.90) compared with males (99.80 ± 7.18). Significant associations were calculated between quadrant RNFL thickness and SA, SE, and CS (all p<0.05). The mean cup to disc ratio (CDR) was 0.49 ± 0.12, and mean optic disc area (DA) was 2.08 mm² ± 0.40. Smaller DA was recorded for participants aged 60+ years (1.86 ± 0.25), followed by 40–59 age group (2.01 ± 0.41) and then 20–39 age group (2.19 ± 0.41). Significant associations were calculated between SA and ONH parameters, except rim area (all p<0.01), and RE was significantly associated with DA and average CDR (all p<0.05). Conclusion. RNFL thickness in healthy black Ghanaian population was significantly higher than that reported in other races. The values and associations reported in this study can inform clinical decision on the normal variation in RNFL and optic disc parameters.