The British journal of ophthalmology
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The frequent lack of association between dry eye (DE) symptoms and signs leads to challenges in diagnosing and assessing the disease. ⋯ 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.