To compare the suitability of the Ocular Surface Disease Index (OSDI) and the 5-item Dry Eye Questionnaire (DEQ-5) in Indian patients with dry eyes.
This cross-sectional study evaluated the OSDI and DEQ-5 in patients with tear film abnormalities. Tear film breakup time, tear film height, Schirmer’s I, lissamine green staining, and meibomian gland expressibility were performed on each patient.
There were 101 patients with symptoms and/or signs of tear film abnormality. Both OSDI and DEQ-5 questionnaires significantly correlated (ρ = 0.566, P < 0.0001) with each other. The OSDI questionnaire showed a good correlation with all dry eye tests, whereas the DEQ-5 correlated significantly only with the tear film breakup time and the lissamine green score. None of the questionnaires correlated with meibomian gland expressibility. The Bland-Altman analysis revealed a marginal bias (-0.01 unit) for DEQ-5. The DEQ-5 scored higher in patients with mild symptoms. While 101 (100%) patients answered all the questions in the DEQ-5, only 19 (18.8%) patients answered all the questions in the OSDI questionnaire. The least responses were recorded in the vision-function-related and environmental trigger subscales of the OSDI.
The OSDI and DEQ-5 scores showed a moderate correlation. The OSDI questionnaire correlated with a higher number of dry eye tests than the DEQ-5. The large number of skipped questions in the vision-function-related and environmental trigger subscales of the OSDI suggests that the questionnaire is not adequately adapted to the Indian population. Patients with a negative OSDI score should be reassessed with the DEQ-5 to exclude symptom positivity.

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