ArticleOphthalmology2017
Predictors of Discordance between Symptoms and Signs in Dry Eye Disease.
Article in Ophthalmology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
88 citing papers in PubMed, 3 syntheses or guidelines pooled it, 156 citations in OpenAlex.
- Prevalence of dry eye disease among children: a systematic review and meta-analysis.BMJ open ophthalmology · 2025Pooled it
- Bridging the gap in managing dry eye disease: a consensus report by the Taiwan society of cataract and refractive surgeons.BMC ophthalmology · 2024Guideline
- Dry eye disease and psychiatric disorders: A systematic review and meta-analysis.European journal of ophthalmology · 2022Pooled it
- Yoga as a cost-effective adjunct therapy for dry eye: clinical outcomes from a 12-week randomized controlled trial.Frontiers in medicine · 2026Trial
- Longitudinal Analysis of Tear Cytokine Ratios in Association with Dry Eye Signs and Symptoms in the Dry Eye Assessment and Management (DREAM) Study.Current eye research · 2025Trial
- Intereye Agreement in Dry-Eye Signs in the DREAM Study: Implications for Future Dry-Eye Trials.Cornea · 2025Trial
- Dry Eye Subtypes in the Dry Eye Assessment and Management (DREAM) Study: A Latent Profile Analysis.Translational vision science & technology · 2022Trial
- Systemic Conditions Associated with Severity of Dry Eye Signs and Symptoms in the Dry Eye Assessment and Management Study.Ophthalmology · 2021Trial
- Trial
- When Dry Eye Is Pain: Frequency and Characteristics of a Pain Phenotype (See Commentary on page 1280.).Ophthalmology · 2026Article
- Ocular Surface Symptoms, Objective Redness, and Intraocular Pressure After a Switch from Fixed Dorzolamide/Timolol to Netarsudil in Latanoprost-Treated Glaucoma and Ocular Hypertension: A Prospective Real-World Cohort Study.Medicina (Kaunas, Lithuania) · 2026Observational
- Long-Term Evolution of Treatment Outcomes with Once-Daily Ciclosporin A 0.1% Cationic Emulsion in Patients with Dry Eye Disease and Severe Keratitis.Ophthalmology and therapy · 2026Article
- ENRICHED trial of preservative-free lubricants in dry eye disease.Scientific reports · 2026Observational
- Cracking the Code: Which Ocular Symptoms Predict Dry Eye Signs? Insights From a Large International Sicca Registry.Arthritis care & research · 2026Article
- Dry Eye Disease: From Mechanisms to Management and Future Directions.Journal of clinical medicine · 2026Review
- Current Diagnosis and Management of Ocular Graft-Versus-Host Disease at a Tertiary Cancer Center.Journal of clinical medicine · 2026Review
- Ocular Surface Microbiota-Derived Lipoteichoic Acid Promotes Dry Eye Disease by Inducing Corneal Inflammation.Investigative ophthalmology & visual science · 2026Article
- Central Nervous System Mechanisms and Treatment Response in Chronic Ocular Surface Pain: Protocol for a Cross-Sectional Observational Phenotyping Study.JMIR research protocols · 2026Observational
- Gut-ocular surface axis in dry eye disease: phenotype-specific mechanisms, evidence, and microbiome-targeted interventions.Frontiers in cellular and infection microbiology · 2026Review
- A comprehensive analysis of dry eye disease clinical trials (2000-2024): research trends and gaps.Frontiers in pharmacology · 2026Article
28 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo investigate predictors of discordance between symptoms and signs in dry eye disease (DED).
designCross-sectional association study.
participantsA total of 648 patients with dry eye from the Groningen LOngitudinal Sicca StudY (GLOSSY), a tertiary dry eye clinic patient cohort from the Netherlands.
methodsPatient symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire. Dry eye signs were assessed by tear osmolarity, Schirmer test, tear breakup time, corneal and conjunctival staining, and meibomian gland dysfunction, all in both eyes, and a composite dry eye signs severity score was calculated from these 6 tests for each patient. Linear regression analysis was used to test the association of discordance between symptoms and signs with a wide range of independent variables (demographic and environmental variables, systemic diseases, ocular traits, and medications).
main outcome measuresPredictors of discordance between symptoms and signs in DED, defined by the difference between the rank score of the OSDI and the rank score of the dry eye signs severity score.
resultsOf the 648 subjects in this cohort, 536 (82.7%) were female and the mean age was 55.8 years (standard deviation, 15.6 years). Significant predictors of greater symptoms than signs were the presence of a chronic pain syndrome, atopic diseases, a known allergy, the use of antihistamines (all P < 0.001), depression (P = 0.003), osteoarthritis (P = 0.008), and the use of antidepressants (P = 0.02). Predictors of lesser symptoms than signs were increased age (P < 0.001) and the presence of Sjögren's disease (P < 0.001) (primary Sjögren's disease, P < 0.001) more than secondary Sjögren's disease (P = 0.08), and graft-versus-host disease (P = 0.04). Furthermore, greater symptoms compared with signs were highly associated with lower self-perceived health (P < 0.001).
conclusionsThis large clinical study has shown that discordance between symptoms and signs in DED is an indicator of self-perceived health. The study found important predictors of greater symptoms to signs but also predictors of lesser symptoms to signs. Awareness of these predictors is helpful in assessing patients with dry eye in clinical practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.