Health Literacy Assessment Tools for Dry Eye Disease: A Scoping Review

Background: Dry eye disease (DED) is a highly prevalent, multifactorial chronic ocular surface disease requiring long-term patient self-management. Patients’ health literacy directly shapes disease cognition, treatment adherence, and prognosis, yet the landscape of health literacy assessment tools in the DED field has never been systematically mapped. Objective: To identify, characterize, and evaluate assessment tools used to measure health literacy in adults and children with DED, and to map the psychometric evidence supporting these tools. Design: Scoping review conducted per Joanna Briggs Institute (JBI) methodologyand reported following the PRISMA-ScR guideline. Eligibility (PCC framework): Population — adults and children with a clinical diagnosis of DED, dry eye syndrome, or keratoconjunctivitis sicca, as well as high-risk sub-populations (e.g., prolonged visual-display-terminal users, contact-lens wearers, and patients with Sjögren's syndrome) and caregivers of pediatric DED patients. Concept — health literacy assessment tools, including DED-specific instruments, culturally adapted generic tools (e.g., HLS-EU-Q, eHEALS, TOFHLA), and closely related constructs (knowledge-attitude-practice, self-management, illness perception, disease knowledge); Context — any clinical, community, or research setting worldwide, published in English or Chinese from inception to 2026. Information Sources: Ten databases will be searched — PubMed, Embase, CINAHL, Web of Science Core Collection, Cochrane Library, PsycINFO, CNKI, Wanfang, VIP, and CBM — complemented by grey literature and reference-list hand-searching. Selection & Charting: Two reviewers will independently screen titles/abstracts and full texts, and chart data using a piloted extraction form. Psychometric properties will be summarized following the COSMIN taxonomy. Analysis: Findings will be presented through descriptive statistics, tabular mapping (tool ×dimension × psychometrics), and narrative synthesis. Meta-analysis will not be conducted. Expected Outputs: A structured evidence map of DED health-literacy measurement tools, identification of research gaps, and recommendations for future instrument development or cross-cultural adaptation in Chinese populations.