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1、Ocular Surface Disease Index(OSDI)2 Ask your patients the following 12 questions, and circle the number in the box that best represents each answer. Then, fill in boxes A, B, C, D, and E according to the instructions beside each. Subtotal score for answers 1 to 5(A) Subtotal score for answers 6 to 9
2、(B) Subtotal score for answers 10 to 12(C) AllMostHalfSomeNone Have you experienced any of the of theof theof theof theof the following during the last week? timetimetimetimetime 1. Eyes that are sensitive to light? . . 43210 2. Eyes that feel gritty?. . . . . . . . . . . 43210 3. Painful or sore ey
3、es? . . . . . . . . . . 43210 4. Blurred vision? . . . . . . . . . . . . . . . 43210 5. Poor vision? . . . . . . . . . . . . . . . . . 43210 Have problems with your eyes AllMostHalfSomeNone limited you in performing any of of theof theof theof theof the the following during the last week?timetimetim
4、etimetimeN/A 6. Reading?. . . . . . . . . . . . . . . . . . . . 43210N/A 7. Driving at night? . . . . . . . . . . . . . . 43210N/A 8. Working with a computer or bank machine (ATM)?. . . . . . . . . . 43210 N/A 9. Watching TV? . . . . . . . . . . . . . . . . 43210N/A Have your eyes felt uncomfortable
5、 AllMostHalfSomeNone in any of the following situations of theof theof theof theof the during the last week?timetimetimetimetimeN/A 10. Windy conditions?. . . . . . . . . . . . . 43210N/A 11. Places or areas with low humidity (very dry)? . . . . . . . . . . . 43210 N/A 12. Areas that are air conditi
6、oned?. . . 43210N/A Add subtotals A, B, and C to obtain D (D = sum of scores for all questions answered) (D) Total number of questions answered (do not include questions answered N/A) (E) Please turn over the questionnaire to calculate the patients final OSDIscore. Evaluating the OSDIScore1 The OSDI
7、is assessed on a scale of 0 to 100, with higher scores representing greater disability. The index demonstrates sensitivity and specificity in distinguishing between normal subjects and patients with dry eye disease. The OSDIis a valid and reliable instrument for measuring dry eye disease (normal, mi
8、ld to moderate, and severe) and effect on vision-related function. Assessing Your Patients Dry Eye Disease1, 2 Use your answers D and E from side 1 to compare the sum of scores for all questions answered (D) and the number of questions answered (E) with the chart below.* Find where your patients sco
9、re would fall. Match the corresponding shade of red to the key below to determine whether your patients score indicates normal, mild, moderate, or severe dry eye disease. 12 11 10 9 8 7 6 5 4 3 2 1 5101520253035404548 Sum of Scores for All Questions Answered (D from Side 1) NormalMildModerateSevere
10、Number of Questions Answered (E from Side 1) 10.420.831.341.752.162.572.983.393.8100.0 11.422.734.145.556.868.279.590.9100.0 12.525.037.550.062.575.087.5100.0 13.927.841.755.669.483.397.2 15.631.346.962.578.193.8100.0 17.935.753.671.489.3100.0 20.841.762.583.3100.0 25.050.075.0100.0 31.362.593.8 41.
11、783.3 62.5 1. Data on file, Allergan, Inc. 2. Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL. Reliability and validity of the Ocular Surface Disease Index. Arch Ophthalmol. 2000;118:615-621 Copyright 1995, Allergan *Values to determine dry eye severity calculated using the OSDIformula. OSDI= (sum of scores) x 25 (# of questions answered) Patients Name: _ Date: _ How long has the patient experienced dry eye disease? _ Eye Care Professionals Comments:_ _ _ _ _
