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J.J. Nichols, L. Sinnott; Factors Associated With Contact Lens–Related Dry Eye . Invest. Ophthalmol. Vis. Sci. 2006;47(13):245.
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© ARVO (1962-2015); The Authors (2016-present)
To examine tear film, contact lens, medical, and patient–related factors associated with self–reported contact lens–related dry eye.
Four hundred and fifteen contact lens wearers were recruited and enrolled in this examination phase of a larger cross–sectional survey study. In the survey phase of the study, patients completed the Contact Lens Dry Eye Questionnaire (Nichols et al, Cornea, 2002 and Nichols et al, IOVS, 2005), which classifies patients with or without dry eye based on self–report. In this phase of the study, a clinical examination was performed on subjects which included a variety of tear film (e.g., interferometry, osmolality, phenol red thread, meibography, fluorescein and lissamine green staining), contact lens (i.e., water content, refractive index, material), and patient–related (e.g., gender, socio–demographic, education, income, and medical health) assessments. Logistic regression models were used to examine the relation between these factors and dry eye status.
Of the 415 enrolled, the data from 360 were used for the analyses described here. The average age was 31.1 ± 11.5 years and 245 (68%) were female. Overall, 327 (90.8%) were hydrogel lens wearers and 33 (9.2%) were gas permeable lens wearers, and 199 (55.3%) participants were classified with dry eye by self–report and 161 (44.7%) participants classified without dry eye by self–report on the CLDEQ. Several factors were shown to be related to dry eye status in multivariate modeling including female gender (odds ratio = 2.25, p = 0.007), higher nominal water content lenses (odds ratio = 1.03, p = 0.002), rapid pre–lens tear film thinning time (odds ratio = 1.05, p = 0.008), frequent usage of over–the–counter pain medication (odds ratio = 2.00, p = 0.02), limbal injection (odds ratio = 0.59, p = 0.03), and increased tear film osmolality (odds ratio = 1.01, p = 0.05).
Contact lens–related dry eye might be explained mechanistically by increased tear film thinning times (which could be attributed to several mechanisms including evaporation or dewetting) resulting in increased tear film osmolality. Other contributing factors include the use of high water content lenses, which have traditionally been reported to be associated with less patient comfort than lower water content lenses, potentially due to spoilation and deposition. As found in other studies of dry eye, women are more likely to report contact lens–related dry eye than men.
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