title: Diagnosing the severity of dry eye: a clear and practical algorithm.
abstract: Dry eye disease (DED) is a distressing ocular condition. Due to its multifactorial nature, clinical and biological signs of DED can be inconsistent and sometimes discordant with symptomatology. Consequently, no gold-standard model for determining DED severity exists. This can impact treatment decisions and complicate evaluation of disease progression, particularly within the stringent context of clinical trials. The multinational ODISSEY European Consensus Group is comprised of ophthalmologists who contend with ocular surface disease issues on a daily basis. This group convened to establish a clear and practical algorithm for evaluation and diagnosis of severe DED. Using a consensus-based approach, they assessed 14 commonly used DED severity criteria. The panel agreed that following confirmed DED diagnosis, just two criteria, symptom-based assessment and corneal fluorescein staining were sufficient to diagnose the presence of severe DED in the majority of patients. In the event of discordance between signs and symptoms, further evaluation using additional determinant criteria was recommended. This report presents the ODISSEY European Consensus Group recommended algorithm for DED evaluation, which facilitates diagnosis of severe disease even in the event of discordance between signs and symptoms. It is intended that this algorithm will be useful in a clinical and developmental setting.
authors.affiliation: Quinze-Vingts National Ophthalmology Hospital, Paris, France UPMC University, Paris 6, Vision Institute, INSERM UMRS968, CNRS UMR7210, Paris, France University of Versailles Saint-Quentin en Yvelines, Versailles, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Baudouin
authors.affiliation: University of Messina, Messina, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Aragona
authors.affiliation: St. Eriks Eye Hospital, Stockholm, Sweden.
authors.forename: Gysbert
authors.initials: G
authors.lastname: Van Setten
authors.affiliation: University of Genoa, Genoa, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Rolando
authors.affiliation: Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Irkeç
authors.affiliation: Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Benítez del Castillo
authors.affiliation: University of Düsseldorf, Düsseldorf & University of Würzburg, Düsseldorf, Germany.
authors.forename: Gerd
authors.initials: G
authors.lastname: Geerling
authors.affiliation: South Paris University, Kremlin-Bicêtre, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Labetoulle
authors.affiliation: University Campus Bio-Medico, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonini
mesh_terms: D000465:Algorithms; D003941:Diagnostic Techniques, Ophthalmological; D018450:Disease Progression; D015352:Dry Eye Syndromes / Q000175:diagnosis*; D006801:Humans; D012720:Severity of Illness Index