Comparison of two methods for composite score generation in dry eye syndrome

Craig See, Richard A. Bilonick, William J Feuer, Anat Galor

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Purpose. To compare two methods of composite score generation in dry eye syndrome (DES). Methods. Male patients seen in the Miami Veterans Affairs eye clinic with normal eyelid, corneal, and conjunctival anatomy were recruited to participate in the study. Patients filled out the Dry Eye Questionnaire 5 (DEQ5) and underwent measurement of tear film parameters. DES severity scores were generated by independent component analysis (ICA) and latent class analysis (LCA). Results. A total of 247 men were included in the study. Mean age was 69 years (SD 9). Using ICA analysis, osmolarity was found to carry the largest weight, followed by eyelid vascularity and meibomian orifice plugging. Conjunctival injection and tear breakup time (TBUT) carried the lowest weights. Using LCA analysis, TBUT was found to be best at discriminating healthy from diseased eyes, followed closely by Schirmer's test. DEQ5, eyelid vascularity, and conjunctival injection were the poorest at discrimination. The adjusted correlation coefficient between the two generated composite scores was 0.63, indicating that the shared variance was less than 40%. Conclusions. Both ICA and LCA produced composite scores for dry eye severity, with weak to moderate agreement; however, agreement for the relative importance of single diagnostic tests was poor between the two methods.

Original languageEnglish (US)
Pages (from-to)6280-6286
Number of pages7
JournalInvestigative Ophthalmology and Visual Science
Issue number9
StatePublished - Sep 19 2013


  • Composite score
  • Dry eye syndrome
  • Independent components analysis
  • Latent class analysis

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience


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