Identifying Ocular Symptoms as Predictors of Dry Eye: Findings from a Comprehensive International Sicca Registry
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By
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Pragnya R. Donthineni
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Chloe Shields
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Rohit Muralidhar
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Shreya Bhatt
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Alan Baer
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Robert Fox
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Sara S. McCoy
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Anat Galor
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May 14, 2026
Clinical Scorecard: Identifying Ocular Symptoms as Predictors of Dry Eye: Findings from a Comprehensive International Sicca Registry
At a Glance
| Category | Detail |
|---|
| Condition | Dry Eye Disease (DED) |
| Key Mechanisms | Ocular dryness, discomfort, soreness, grittiness, burning, and poor/fluctuating vision. |
| Target Population | Individuals with sicca symptoms, particularly those with Sjögren disease. |
| Care Setting | Rheumatology clinics and eye clinics. |
Key Highlights
- Ocular symptoms in DED include dryness, discomfort, soreness, grittiness, and burning.
- Symptom-based clustering reveals distinct levels of symptom burden.
- Abnormal serologic test results are more frequent in mild-moderate symptom clusters.
- DED symptoms often discordant with clinical signs.
- Visual analog scale for eye dryness shows weak correlation with ocular surface damage.
Guideline-Based Recommendations
Diagnosis
- Utilize composite questionnaires like DEQ5 and OSDI to assess symptoms.
Management
- Tailor management strategies based on identified SjD phenotypes.
Monitoring & Follow-up
- Monitor ocular surface staining and tear production using appropriate tests.
Risks
- Consider potential discordance between symptoms and clinical signs in DED.
Patient & Prescribing Data
Individuals aged ≥21 years with sicca symptoms, including those with suspected or established Sjögren disease.
Artificial tear use and blurred vision are stronger predictors of DED signs than pain symptoms.
Clinical Best Practices
- Assess both symptoms and signs for a comprehensive evaluation of DED.
- Use symptom-based clustering to identify unique SjD phenotypes.
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