Abstract
Purpose :
To determine the association between environmental factors and dry eye symptoms and signs in subjects of the DRy Eye Assessment and Management (DREAM©) Study.
Methods :
Moderate to severe dry eye (DE) subjects were evaluated at baseline with Ocular Surface Disease Index (OSDI), Brief Ocular Discomfort Index (BODI), conjunctival lissamine green staining, corneal fluorescein staining, tear film break up time (TBUT), and 5-minute Schirmer’s test with anesthesia. The same-day daily average temperature, humidity, wind speed, dew point, ozone, toxic and poisonous gases e.g. carbon monoxide, nitrogen oxides, sulfur dioxide, and particulate matter were abstracted from National Oceanic and Atmospheric Administration (NOAA) records. AOD (Aerosol Optical Depth, an air pollution equivalent) was abstracted from NOAA and NASA public sites, and total pollen was obtained from National Allergy Bureau (NAB) pollen counting stations. The Pearson correlation coefficient (ρ) was used for assessing statistical significance.
Results :
Among 535 subjects, 81% were female, and mean age was 58 years. Of the DE symptoms (Table 1), the OSDI subscale of environmental triggers were inversely correlated with humidity (ρ=-0.13, p<0.01) and total pollen count (ρ =0.25, p<0.01). BODI was correlated with total pollen count (ρ=0.18, p<0.05). Of DE signs (Table 2), corneal fluorescein dye staining was inversely correlated with humidity (ρ=-0.16, p<0.001). TBUT was positively correlated with both humidity and dew point (ρ =0.20, p<0.001; ρ=0.18, p<0.001, respectively), but was inversely correlated with AOD (ρ=-0.22, p<0.001).
Conclusions :
For DREAM© subjects, DE symptoms were correlated with local pollen count at baseline visit. Of DE signs, lissamine green and Schirmer’s tests had no statistical correlation to weather, pollution, and pollen, but TBUT and to a lesser degree corneal staining were associated with environmental factors. These findings confirm long-held clinical suspicions and the results of retrospective studies on the negative impact of environmental factors on DE symptoms. For DE patients in polluted, pollinated, and arid climates, strategies directed at control of environmental triggers may be beneficial.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.