Dry eye disease in the Australian Eye and Ear Health Survey

Abstract

Purpose : The Australian Eye and Ear Health Survey is a national population-based survey, which aims to estimate the prevalence of hearing loss and eye conditions which cause vision-impairment, in non-Indigenous Australians aged 50, and Indigenous Australians aged 40 years and over. The prevalence of non-blinding eye diseases, including dry eye disease (DED) is a secondary outcome and was estimated from preliminary data.

Methods : Residents from selected Statistical Local Areas in urban Sydney were invited to participate in the survey in 2022. Participants were asked about recent attendance at an eye health professional and DED: 'Have you ever been told you have dry eyes? 'and 'Do you use any lubricating drops?' The daily frequency of lubricant use and how much was spent on lubricating drops in 1 month were self-reported. Tear break up time was measured with sodium fluorescein (FBUT) and corneal staining graded using the Oxford Scale (0-5). Participants completed the Ocular Surface Disease Index (OSDI) questionnaire as part of a supplementary take-home questionnaire. An OSDI score of 13 or higher and corneal staining (grade 1 or above) or FBUT < 10 seconds were used as diagnostic criteria for DED.

Results : Of 357 participants examined, 47% male (169/357), 53% female (188/357), age 69.8 ± 10.6 years (mean ± standard deviation, range 50-100) and 1.9% (6/357) were Aboriginal; 323 responded to the self-report of DED items and 122 completed the OSDI. Most participants had recently been examined by an eye health professional (96%, 316/328), on average within last 18 months, and saw an optometrist (72%, 227/315), ophthalmologist (28%, 87/315) or ophthalmic nurse or technician (n=1). Of 323 responses, 26% (85/323) had been told they have DED, 24% (78/323) used lubricating drops: 2.0 ± 1.3 times per day (range 1-8 times) and spent a median of $AU10 per month on lubricating drops. There were 13% (15/120) with clinical signs and symptoms consistent with a diagnosis of DED and the OSDI scores suggested 8.2% had mild, 2.5% moderate and 1.6% severe DED. Of those meeting diagnostic criteria for DED, 40% (6/15) had been told they had DED and 47% (7/15) reported using lubricating drops.

Conclusions : The prevalence of DED is significant in older Australians and is broadly consistent with estimates from population studies elsewhere. Weighted estimates based on national data from the Australian Eye and Ear Health Survey will be useful for planning services.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.