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Venkiteshwar S Manoj; Prevalence of hyperosmolarity and symptoms of DED in the US population. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2860.
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© 2017 Association for Research in Vision and Ophthalmology.
Tear film hyperosmolarity is a core and early mechanism of dry eye disease (DED) that causes significant damage to ocular surface. An observational study was conducted to estimate the prevalence of tear hyperosmolarity among patients visiting ophthalmology clinics and compare its prevalence among symptomatic and asymptomatic patients.
Data was collected from 9,947 subjects visiting 100+ eye care clinics in USA. All subjects were tested for tear osmolarity and reported on demographic information, presence of symptoms associated with dry eye (fluctuating vision, light sensitivity, watery eyes, tired eyes, redness, burning, itching, grittiness, CL discomfort), and ocular status: contact lens (CL) wear, previous cataract and/or refractive surgery, and use of glaucoma medication.
Tear hyperosmolarity was prevalent in 46.3% of all subjects, with 29% of all subjects exhibiting moderate dry eye ≥ 316 mOsm/L. 44.2% of males and 47.4% of females had hyperosmolarity. No significant association was measured between age and number of symptoms nor age and the presence of hyperosmolarity, as 81% of all patients presenting to the clinic checked at least one symptom associated with dry eye disease. The most common symptoms measured being tired eyes in 35.9% and itching sensation in 35.7% of all subjects. There was a higher percentage of patients with hyperosmolarity in those with 3 or more symptoms (48.9%) as compared to patients with 0–2 symptoms (44.2%). The percent of all patients exhibiting both hyperosmolarity and CL wear was 20.4%, post cataract surgery 21.1%, post refractive surgery 9.0%, and use of glaucoma medication 6.0%. Among subjects who use artificial tears, 45.7% were hyperosmolar vs 44.4% with normal osmolarity.
These findings highlight the lack of specificity of symptoms in DED diagnosis and management, and suggests that many overlapping conditions such as allergy or mechanical insults to the ocular surface present identically to classical dry eye disease. Assessment of tear osmolarity provides an objective measure of ocular surface stress and could allow more targeted therapy and monitoring, identifying those patients for which artificial tears alone are insufficient and may require pharmaceutical or surgical intervention.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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