Questionnaire McMonnies Questionnaire (Caffery)

DEWS
DRY EYE: DIAGNOSTIC TEST TEMPLATE

Barbara Caffery Date: 22/10/04
RAPPORTEUR
TEST McMonnies questionnaire

Presence or absence of dry eye REFERENCES
TO
DIAGNOSE
VERSION of [V2] Mc Monnies 1987
TEST
DESCRIPTION The test is used to screen patients for the possibility of dry
eye disease so that the index of suspicion of the practitioner is
raised for those at risk and therefore further testing would be
performed.
CONDUCT of The test is self administered:
TEST A questionnaire with 14 questions is given to the patient to
fill out. The weighted values for questions are as follows.
Previous treatment of dry eye:
yes=2,
no=0,
uncertain=1
Experience of symptoms: the presence of each symptom=1
Frequency of symptoms:
never=0,
sometimes =1,
often=2,
constantly=3
Unusual sensitivity of the eyes:

yes=2,
no=0,
sometimes=1
Swimming irritation of the eyes:

yes=2,
no=0,
sometimes=1
Alcohol use: yes=2, no=0, sometimes=1

Medication side effects: each medication =1
Arthritis: yes=2, no=0,uncertain=1
Mucous membrane dryness:
never=0,
sometimes=1,
often=2,
constantly=3
Thyroid abnormality:
yes=2,
no=0,
uncertain=1
Nocturnal lagophthalmos:
yes=2,
o=0,
uncertain=1
Waking irritation:
yes=2,
no=0,
uncertain=1
1
Web Video NA
Materials: A single sheet of paper with the questionnaire on it that
includes the weighted scores.
Variations of Some practitioners may not use the scoring system but just
technique use the answers directly, in their decision making.
Diagnostic This version [v2]: [1987] To discriminate between normals Mc Monnies 1986;
value and sicca syndrome. See below for sensitivity 1987.
Other version [V1]: [1986] Not as good on its own at
identifying marginal dry eye..
.
Repeatability Intra-observer agreement. [ ]
Inter-observer agreement. [ ]
Sensitivity (true positives) [98%]
Specificity (100 – false positives) [ 97%]
Other Stats Mc Monnies 1986 refers to a different weighting system for

the same questionnaire that was used to discriminate marginal
dry eye from normals and more severe dry eye. The authors
determined that neither history nor biomicroscopy alone were
adequate to determine marginal dry eye. However, using the
history to identify the top 10% of total scores, a high level of
sensitivity was obtained..
Test problems The questionnaire is not good at categorizing the patients as
mild, moderate or severe.
References
McMonnies C, Ho A, Marginal dry eye diagnosis, in Holly F (ed). The preocular tear film in health, disease and
contact lens wear. 1986, Dry Eye Institute Inc: Lubbock, p 32-38.
McMonnies C, Ho A. Patient history in screening for dry eye conditions. J Am Optom Assoc 1987;58(4): 296-
301.
McMonnies C. Responses to a dry eye questionnaire from a normal population. J Am Optom Assoc 1987;58:
588-589.
The McMonnies questionnaire:
Please answer the following by underlining the response most appropriate to you.
Age: under 25 years 25-45 years over 45 years
Currently wearing: no contact lenses hard contact lenses soft contact lenses
2
1. Have you ever had drops prescribed or other treatment for dry eye?
Yes (2) No (0) Uncertain (1)
2. Do you ever experience any of the following symptoms? (Please underline those that apply to you)
1. soreness (1) 2. scratchiness (1) 3. dryness (1) 4. grittiness (1)

5. burning (1)
3. How often do your eyes have these symptoms? (Underline)
Never (0) Sometimes (1) Often (2) Constantly (3)
4. Do you regard your eyes as being unusually sensitive to cigarette smoke, smog, air conditioning, central
heating?
Yes (2) No (0) Sometimes (1)
5. Do your eyes easily become very red and irritated when swimming in chlorinated fresh water?
Nor applicable Yes (2) No (0) Sometimes (1)
6. Are your eyes dry and irritated the day after drinking alcohol?
Not applicable Yes (2) No (0) Sometimes (1)
7. Do you take (please underline) antihistamine tablets (1), antihistimine eye drops(1). diuretics (fluid
tablets) (1), sleeping tablets (1), tranquilizers (1), oral contraceptives (1), medication for duodenal
ulcer (1) or digestive problems (1) or for high blood pressure (1) or ___________ (1)
8. Do you suffer from arthritis?
9. Do you experience dryness of the nose, mouth, throat, chest or vagina?
Never (0) Sometimes (1) Often (2) Constantly (3)
10. Do you suffer from thyroid abnormality?
11. Are you know to sleep with your eyes partly open?
12. Do you have eye irritation as you wake from sleep?

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DEWS

DRY EYE: DIAGNOSTIC TEST TEMPLATE

TEST McMonnies questionnaire

Unusual sensitivity of the eyes:

Swimming irritation of the eyes:

Alcohol use: yes=2, no=0, sometimes=1

Specificity (100 – false positives) [ 97%]

Other Stats Mc Monnies 1986 refers to a different weighting system for

The McMonnies questionnaire:

Age: under 25 years 25-45 years over 45 years

Yes (2) No (0) Uncertain (1)

1. soreness (1) 2. scratchiness (1) 3. dryness (1) 4. grittiness (1)

3. How often do your eyes have these symptoms? (Underline)

Never (0) Sometimes (1) Often (2) Constantly (3)

Yes (2) No (0) Sometimes (1)

Nor applicable Yes (2) No (0) Sometimes (1)

Not applicable Yes (2) No (0) Sometimes (1)

8. Do you suffer from arthritis?

Yes (2) No (0) Uncertain (1)

9. Do you experience dryness of the nose, mouth, throat, chest or vagina?

Never (0) Sometimes (1) Often (2) Constantly (3)

10. Do you suffer from thyroid abnormality?

Yes (2) No (0) Uncertain (1)

Yes (2) No (0) Uncertain (1)

12. Do you have eye irritation as you wake from sleep?

Yes (2) No (0) Uncertain (1)

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