Abstract
Purpose: :
To explore factors associated with severity of symptoms in a community sample of men and women who reported a diagnosis of dry eye disease (DED).
Methods: :
In a cross-sectional survey of 4000 participants in the Women’s Health Study and Physicians’ Health Studies with previously diagnosed DED or severe symptoms, we assessed the current level of DED symptoms as measured by Ocular Surface Disease Index (OSDI), co-morbidities, treatments, patient satisfaction, and impact of disease. Data from 1925 respondents (1390 women and 535 men) who confirmed a reported diagnosis of DED were analyzed using logistic regression.
Results: :
The mean age was 72.4 years and mean DED duration was 10.4 years. Severe DED (OSDI score >32) was present in 28.8% of participants with another 14.9% with moderate DED (23<= OSDI score <=32). Co-morbidities included blepharitis (14.4%), rosacea (12.7%), corneal ulcer (6.0%), Sjögren’s syndrome (4.0%), and meibomiam gland dysfunction (2.4%). In multivariable models, participants with severe DED were more likely to be female (Odds Ratio [OR]=2.84, p<0.0001), and to report poorer overall health (OR=1.37 per grade increase; max 4 grade changes), depression (OR=1.59; p=0.003), use of artificial tears (OR=1.64, p=0.004), previous eye surgery (OR=1.47, p=0.005), blepharitis (OR=1.54, p=0.013), and Sjögren’s syndrome (OR=1.75, p=0.049). There was no association between severe DED symptoms and duration of DED (per 5 years, OR=0.94, p=0.51).
Conclusions: :
These cross-sectional data from a large group of men and women with a self-reported diagnosis of DED do not support a strong association between the duration of DED and the severity of symptoms. Adjusting for age, sex, and disease duration, participants with severe symptoms of DED had poorer overall health, and increased prevalence of depression, previous eye surgery, blepharitis, Sjögren’s syndrome, and artificial tear use.
Keywords: cornea: tears/tear film/dry eye • clinical (human) or epidemiologic studies: natural history • clinical (human) or epidemiologic studies: risk factor assessment