Conclusions The present study provides evidence that the degree of discordance between DE symptom report and measurable signs of ocular surface disease is associated with comorbidities related to clinical pain and to hyperalgesia as demonstrated with QST. Understanding the epidemiology of DE discordance can aid in interpreting the DE exam and individualising treatment.

British Journal of Ophthalmology  Published Online First: 18 August 2017. doi: 10.1136/bjophthalmol-2017-310633