Dry Eye Cross-Sectional Study – Philippines: Comparison with the Asia Dry Eye Society Criteria and OCULUS Keratograph 5M Findings

Authors

  • Ruben Lim Bon Siong, MD Department of Ophthalmology and Visual Sciences, Philippine General Hospital, University of the Philippines Manila, Philippines; Eye Institute, St. Luke’s Medical Center-Quezon City, Philippines Author
  • Bobbie Marie Santos, MD Department of Ophthalmology and Visual Sciences, Philippine General Hospital, University of the Philippines Manila, Philippines Author
  • Keshia Duyongco-Lenon, MD Eye and Vision Institute, The Medical City, Pasig City, Philippines Author
  • Jessica Marie Abaño, MD Eye Institute, St. Luke’s Medical Center-Quezon City, Philippines; Eye Institute, University of the Santo Tomas Hospital, Manila, Philippines; Department of Health Eye Center, East Avenue Medical Center, Quezon City, Philippines Author
  • Reynaldo Santos, MD Eye and Vision Institute, The Medical City, Pasig City, Philippines; Department of Health Eye Center, East Avenue Medical Center, Quezon City, Philippines Author
  • Ivo John Dualan, MD Department of Ophthalmology and Visual Sciences, Philippine General Hospital, University of the Philippines Manila, Philippines; Eye and Vision Institute, The Medical City, Pasig City, Philippines Author

Keywords:

dry eye disease, Asia Dry Eye Society, ADES criteria, keratograph, Philippine dry eye criteria

Abstract

Objective: This study compared the proportion of dry eye disease (DED) diagnosed using the Philippine criteria with that diagnosed using the Asia Dry Eye Society (ADES) criteria among participants, and characterized DED features using clinical tests and the OCULUS Keratograph® 5M (K5M; OCULUS Optikgeräte GmbH, Wetzlar, Germany).

Methods: This multicenter, cross-sectional study included participants with and without DED. Participants completed the Ocular Surface Disease Index (OSDI) questionnaire and underwent fluorescein tear breakup time (FTBUT) measurement, fluorescein staining of the cornea, lissamine green staining of the conjunctiva, Schirmer 1 test without anesthesia, and basal tear secretion test (BST). The OCULUS K5M was used to measure noninvasive tear breakup time (NIKBUT) and tear meniscus height (TMH), and to perform meibography.

Results: The analysis included 344 eyes from 172 patients with DED and 44 eyes from 22 normal participants. Patients with DED were mostly female (66.3%). Compared to normal participants, patients with DED were older (42.7 ± 14.6 years) and had higher OSDI scores (28.6 ± 21.0). Among those diagnosed with DED using the Philippine criteria, 53.2% met the ADES criteria. Evaporative DED was the predominant type (53.2%). DED eyes had lower FTBUT (5.0 ± 3.3 seconds) and NIKBUT (12.3 ± 5.9 seconds) than controls (p <0.001). The correlation between FTBUT and NIKBUT was weak in the overall sample (r = 0.27, p < 0.001). The DED group also had a lower BST value (12.7 ± 9.8 mm) than the control group (p <0.001), while TMH (0.29 ± 0.15 mm) of the DED group did not differ from that of the control group (p = 0.421). BST and TMH also showed weak correlation (r = 0.21, p <0.001).

Conclusion: There were disparities between the Philippine and ADES criteria for DED diagnosis and differences in tear measurements using clinical tests and the OCULUS Keratograph, indicating the need to harmonize diagnostic standards

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Published

2025-06-29

Issue

Vol. 50 No. 1

Section

Original Research

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Copyright (c) 2025 Philippine Journal of Ophthalmology

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