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S.E. Moss, R. Klein, B.E. Klein; Incidence of Dry Eye in an Older Population . Invest. Ophthalmol. Vis. Sci. 2003;44(13):810.
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Purpose: To estimate the five-year incidence of dry eye in an older population and to examine its association with various risk factors. Methods: The population of Beaver Dam, WI, that was 43 to 86 years of age (n=5924) was examined in 1988-90 (n=4926), 1993-95 (n=3722), and 1998-2000 (n=2962). At both the 1993-95 examination, when dry eye data were first collected, and the 1998-2000 examination, 2783 subjects participated, and an additional 44 were interviewed in 1998-2000. Of these, 2802 provided dry eye information by history. Subjects reporting dry eye in 1993-95 (n=388) were not considered at risk of incidence. Thus, the incidence cohort comprised the remaining 2414 subjects. Risk factor information was ascertained at the 1993-95 examination and included demographics, medical history, cardiovascular disease risk factors, medications, and life-style factors. Results: Over the 5-year interval between examinations, 322 of 2414 subjects developed a history of dry eye for an incidence of 13.3% (95% confidence interval: 12.0-14.7%). Dry eye incidence was significantly (p<.001) associated with age, increasing from 10.7% in subjects 48-59 years of age to 17.9% in those 80 years or older. Controlling for age, the incidence of dry eye was greater in women than in men (relative risk: 1.22, 95% CI: 0.99-1.50), but this difference was not statistically significant (p=.06). After adjusting for age, incidence of dry eye was more likely (p<.05) in subjects with history of allergy or diabetes, using antihistamines or diuretics, and with poorer self-rated health. It was directly associated with serum total cholesterol but not significantly (p=.06). Age-adjusted dry eye incidence was less likely (p<.05) in subjects using ACE inhibitors or consuming alcohol. It was not associated with blood pressure, hypertension, serum HDL cholesterol, body mass, history of arthritis, gout, osteoporosis, cardiovascular disease, or thyroid disease, smoking, or use of caffeine, vitamins, antianxiety medications, antidepressants, calcium channel blockers or anticholesterol medications. Conclusions: Incidence of dry eye is substantial. However, there are few associated risk factors. Some drugs (diuretics, antihistamines) are associated with a greater risk while others, such as ACE inhibitors, may be associated with lower risk.
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