Interpretation of a SPEED questionnaire

Jerry Robben, O.D.
Chief Optometrist
Bowden Eye & Associates
Professor at Dry Eye University

The SPEED (Standard Patient Evaluation of Eye Dryness) questionnaire is useful guide to help identify unknowing patients who have Ocular Surface Disease or to help drive an established patient’s OSD exam. It allows the physician to quickly assess how symptomatic a patient is on that given exam, which can be related to what the physician is or isn’t seeing upon further examination and testing. The SPEED also drives the progression of an OSD exam, guiding the technician, counselor and physician to consult the patient appropriately and to order and preform appropriate OSD testing at that visit or in the future. These diagnostic tests help to better diagnosis, track and explain OSD to the physician and patient alike. Especially in a low or non-symptomatic patient.

Interpretation of the SPEED is quite easy, when preformed accurately. My approach is to first look at the SPEED score, which is derived by adding up the values to the positive responses in the SYMPTOM FREQUENCY and SYMPTOM SEVERITY check boxes. This number is a quick reference to determine how symptomatic a patient is feeling. Below is how we assign a severity rating to the SPEED Score:
0-4 Mild
5-7 Moderate
8+ Severe

Note: A low SPEED score, or even a 0 SPEED Score, does not mean a patient does not have Ocular Surface Disease, or does not need further testing or treatments. Again, the SPEED is an assessment to help identify new OSD patients, guide a patient’s individual exam and testing; and, is another metric to help allow the individual patient to be monitored visit to visit. It does not stand alone to diagnose a patient.

At Bowden Eye & Associates we have modified our SPEED Questionnaire to include additional symptom assessments that can be related to Allergic Ocular Disease and Autoimmune contributing factors. After reviewing the SPEED Score, I then look to see if any of these allergy or autoimmune assessments have been identified as present. If they are, I then can easily make the order to have appropriate, special testing to evaluate for the presence of Ocular Allergies and/or Autoimmune Factors to better assess, understand and treat my patient’s overall Ocular Surface Disease.

With understanding of the SPEED Questionnaire, all this can be done in a matter of seconds. I can quickly understand my patient’s symptomology and know what I am possibly looking for. The medical necessity can be discussed and documented in my exam note and the appropriate tests can be ordered with follow up before I have even looked at the patient under the slit lamp. And, I can relate what I am seeing to their specific symptoms reported.

Upon follow up the SPEED should be repeated to assess if any improvement or worsening of symptoms has been perceived by the patient, which continues to drive the patient’s examination, testing and discussions appropriately and keeps the physician and his team in tune with what the patient is experiencing.