Abstract
Purpose :
To elucidate the association between demographical characteristics, geographic residence, and psychiatric comorbidity with dry eye in a clinic-based sample of the geriatric population.
Methods :
Patients with clinically significant dry eye, defined as 2 or more dry eye claims submitted in a single calendar year, were identified using international classification of diseases codes (ICD-9) (375.15, 370.33) from a 5% random sample of 2011 Medicare beneficiaries residing within the contiguous United States. Individuals under 65 or with missing demographic information were excluded. Patients with a depression (296.2, 296.3, 300.4, 311) or anxiety disorder diagnosis (300.0, 300.0X, 300.2X, 300.3, 300.30, 309.8X) were likewise identified. Demographic characteristics including age, gender, race/ethnicity, state, county, and median county income were collected. Odds ratios between dry eye and anxiety and depression, controlling for demographical covariates, were generated using logistic regression models.
Results :
A total of 21,059 clinically significant dry eye patients were identified. The average age of individuals in the sample was 75 years. Women were 2.03 times more likely to have dry eye compared to men (p<0.01). Patients of Asian (OR 1.85, p<0.01) or Native American race (OR 1.51, p<0.01) had higher odds of being diagnosed with dry eye compared to White patients, while Black patients were less likely to have a dry eye diagnosis (OR 0.83, p<0.01). Compared to patients residing in the Northeast, patients in the West were more likely to have dry eye (OR 1.38, p<0.01), while patients in the Northwest were less likely to have dry eye (OR 0.58, p<0.01). No observable pattern was seen between income decile and dry eye diagnosis. Compared to patients aged 65-74, patients aged 75-84 (OR 1.49, p<0.01) and 85+ (OR 1.54, p<0.01) were more likely to have dry eye. Having both depression and anxiety was more highly associated with dry eye (OR 2.38, p<0.01) compared to having depression (OR 1.95, p<0.01) or anxiety (OR 2.22, p<0.01) alone.
Conclusions :
Gender, age, race, and geography influence the prevalence of dry eye. Controlling for these covariates, there still exists a significant association between dry eye and depression and/or anxiety in the geriatric population. Longitudinal studies evaluating the temporal relationship between dry eye and psychiatric disease are warranted.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.