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Rhett M. Schiffman, MD, MS; Murray Dale Christianson, MD, FRCSC; Gordon Jacobsen, MS; Jan D. Hirsch, PhD; Brenda L. Reis, PhD

Arch Ophthalmol. 2000;118:615-621.

Objective  To evaluate the validity and reliability of the Ocular Surface Disease Index (OSDI) questionnaire.

Methods  Participants (109 patients with dry eye and 30 normal controls) completed the OSDI, the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25), the McMonnies Dry Eye Questionnaire, the Short Form-12 (SF-12) Health Status Questionnaire, and an ophthalmic examination including Schirmer tests, tear breakup time, and fluorescein and lissamine green staining.

Results  Factor analysis identified 3 subscales of the OSDI: vision-related function, ocular symptoms, and environmental triggers. Reliability (measured by Cronbach ) ranged from good to excellent for the overall instrument and each subscale, and test-retest reliability was good to excellent. The OSDI was valid, effectively discriminating between normal, mild to moderate, and severe dry eye disease as defined by both physician's assessment and a composite disease severity score. The OSDI also correlated significantly with the McMonnies questionnaire, the National Eye Institute Visual Functioning Questionnaire, the physical component summary score of the Short Form-12, patient perception of symptoms, and artificial tear usage.

Conclusions  The OSDI is a valid and reliable instrument for measuring the severity of dry eye disease, and it possesses the necessary psychometric properties to be used as an end point in clinical trials.

From the Department of Eye Care Services, Henry Ford Health System, Detroit, Mich (Drs Schiffman and Christianson and Mr Jacobsen), and Allergan Inc, Irvine, Calif (Drs Hirsch and Reis).

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