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Severity Grading Criteria for Dysfunctional Tear Syndrome
| Group | Symptom Severity Score¥ | Tear Breakup Time (seconds) | Conjunctival Staining Score | Corneal Staining Score |
|---|---|---|---|---|
| No DTS | ≤ 20 | > 7 | 0 | 0 |
| DTS 1 | > 20 | ≤ 7 | ≤ 3 | ≤ 2 |
| DTS 2 | > 20 | ≤ 7 | ≥ 3 | ≤ 8 |
| DTS 3 | > 20 | ≤ 7 | ≥ 3 | > 8, including central cornea or filaments |
| DTS 4 | > 20 | ≤ 7 secs | ≥ 3 | ≥ 12 |
DTS = dysfunctional tear syndrome; DTS 1–4 = DTS severity levels 1–4
symptom severity score measured by ocular surface disease index (OSDI) questionnaire
