title: Association between symptoms and signs of dry eye among an elderly Chinese population in Taiwan: the Shihpai Eye Study.
abstract: OBJECTIVE
  To analyze the association between dry-eye symptoms and signs in an elderly Chinese population in Taipei, Taiwan.
  
  
  METHODS
  The participants were those of the Shihpai Eye Study, a population-based survey of eye diseases in the elderly (> or =65 years) in Shihpai, Taipei, Taiwan. Of 2045 randomly selected noninstitutionalized residents, 1361 (66.6%) participated in the study. Dry-eye symptoms were evaluated with an interviewer-administered questionnaire. Dry-eye signs, including tear-film breakup time, Schirmer test result, score for fluorescein staining of the cornea, and meibomian gland dysfunction, were assessed. Correlations between symptoms and signs were analyzed.
  
  
  RESULTS
  Of the participants, 33.7% (459/1361) were symptomatic, defined as reporting one or more symptoms often or all the time. A Schirmer result of < or =5 mm was the only sign associated with frequent symptoms (P = 0.028). Its sensitivity and specificity in detecting symptomatic subjects were 62.5% and 43.7%, respectively. The agreement between each sign was statistically significant, although weak, except that no correlation was found between the Schirmer result and meibomian gland anomalies. Of the symptomatic subjects, 85.4% (392/459) had either a low Schirmer result or a meibomian gland anomaly; 38.8% (178/459) of them were abnormal on both tests.
  
  
  CONCLUSIONS
  The Schirmer test was shown to be incapable of detecting meibomian gland disease. However, a low Schirmer result was significantly associated with dry-eye symptoms in this elderly Chinese population. This result differs from that of previous reports of elderly white populations. Further studies are needed to determine whether this difference indicates racial diversity in the distribution and behavior of dry-eye diseases.
authors.affiliation: Department of Ophthalmology, National Yang Ming University School of Medicine and Taipei Veterans General Hospital, #201 Sec. 2 Shih-Pai Road, Taipei, Taiwan.
authors.forename: Pei-Yu
authors.initials: PY
authors.lastname: Lin
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Cheng
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Hsu
authors.forename: Su-Ying
authors.initials: SY
authors.lastname: Tsai
authors.forename: Ming-Wei
authors.initials: MW
authors.lastname: Lin
authors.forename: Jorn-Hon
authors.initials: JH
authors.lastname: Liu
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D003941:Diagnostic Techniques, Ophthalmological; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000208:ethnology*; D005141:Eyelid Diseases / Q000175:diagnosis* / Q000208:ethnology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008537:Meibomian Glands / Q000473:pathology*; D015995:Prevalence; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology