June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Dry Eye and Systemic Diseases
Author Affiliations & Notes
  • Claudia Henrich
    Cornea, The Wilmer Eye Institute at Johns Hopkins, Baltimore, MD
  • Esen Akpek
    Cornea, The Wilmer Eye Institute at Johns Hopkins, Baltimore, MD
  • Footnotes
    Commercial Relationships Claudia Henrich, None; Esen Akpek, Alcon (F), Allergan (F), Baush & Lomb (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 931. doi:
  • Views
  • Share
  • Tools
    • Alerts
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Claudia Henrich, Esen Akpek; Dry Eye and Systemic Diseases. Invest. Ophthalmol. Vis. Sci. 2013;54(15):931.

      Download citation file:

      © ARVO (1962-2015); The Authors (2016-present)

  • Supplements

Purpose: To evaluate the prevalence of associated inflammatory systemic diseases in a cohort of patients with dry eye syndrome.

Methods: Medical records of patients who presented to the Wilmer Eye Institute Ocular Surface Diseases and Dry Eye Clinic with dry eye symptomatology during a period of two years (January 2010 to December 2011) were reviewed retrospectively. Patients were divided into two groups: patients with clinically significant dry eye disease (defined as Schirmer test result without topical anesthesia ≤10 mm at 5 minutes in either eye or bulbar conjunctival staining with lissamine green scored based on Oxford scale ≥1 in either eye) and patients with dry eye symptomatology but without the clinical findings.

Results: A patient list of 326 patients was generated electronically using a diagnostic code of ICD 375.15. Sixty two patients were excluded as they presented primarily with other ocular surface problems and dry eye was a secondary diagnosis. Two hundred and sixty four patients with a primary diagnosis of dry eye were included in the analysis. The majority of the patients (215/264, 81.4%) were female. Two hundred and seventeen (217/264; 82.2%) had clinically significant dry eye. About half of the patients (121/264, 45.8%) had an underlying inflammatory systemic disease on presentation. One hundred and nine of them (109/121, 90.1%) had a clinically significant dry eye. Thirty one patients (31/264, 11.7%) had primary Sjögren Syndrome, 38 (38/264; 14.4%) had thyroid disease (either hypothyroidism, Graves disease or Hashimotos thyroiditis), 13 (13/264, 4.9%) had rheumatoid arthritis, 42 (42/264, 15.9%) had other rheumatic diseases. In 50 patients (50/143, 35.0%) without a previously known systemic disease (regardless of the severity of the dry eye) a further work up was performed based on review of systems. In 12 patients (12/50, 24.0%) a diagnosis based on the work up was established: 10 patients (10/50, 20.0%) were diagnosed with thyroid eye disease, 2 patients (2/50, 4.0%) were diagnosed with Sjögren syndrome or presumed Sjögren syndrome, one (1/50, 2.0%) was diagnosed with a mixed connective tissue disease.

Conclusions: Dry eye is a very common condition. Although usually a local disease with a benign course, prevalence of systemic disease association seems to be significant. Based on clinical suspicion and review of systems, further diagnostic testing might uncover some of these previously undiagnosed conditions.

Keywords: 486 cornea: tears/tear film/dry eye • 432 autoimmune disease  

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.