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Laura M. Tarko, Jim Z. Li, Darlene A. Dartt, Debra A. Schaumberg; The Natural History Of Dry Eye Disease From The Patient's Perspective. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5442.
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Dry eye disease (DED) is a chronic disease that causes patients to suffer from symptoms of ocular dryness and irritation and a decreased quality of life. It remains unknown whether the condition is progressive, and there is little information available on the long term natural history of DED. This study aimed to assess the natural history of DED from the patient’s perspective by the percentage of patients who reported that their DED worsened since diagnosis, and to identify factors associated with worsening.
We sent questionnaires to 800 participants in the Physicians’ Health Study (men) and Women’s Health Study (women) who previously reported a diagnosis of DED. Study participants were asked 20 questions to evaluate the degree to which various aspects (such as quality of vision, severity of symptoms, and frequency of symptoms) of their DED changed since DED diagnosis.
The questionnaire was returned by 398 men (mean age, 76.7 years), and 386 women (mean age, 70.8 years), with an average duration of DED of 10.3 and 14.5 years, respectively. Overall, 21.1% of men and 29.8% of women reported worsening of their DED since diagnosis. In multivariable models, females were 45% more likely to indicate worsening (P=0.09). Use of systemic beta-blockers (P=0.04), and past history of severe symptoms (P<0.0001) were associated with worsening, whereas older age, longer duration of DED, current use of glaucoma medications, and other factors were not.
We conclude that most people with DED do not experience worsening over time. When it does occur (in about 20-30% of cases), worsening is more likely to be seen among women, people who take systemic beta-blockers, and among those who experience severe symptoms earlier in the course of their disease.
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