Abstract
Purpose :
Dry Eye Disease (DED) is increasingly prevalent in younger populations. The current study investigated lifestyle factors, and clinical signs and symptoms, in young adults with evaporative DED, compared with healthy participants, and for progression over one year.
Methods :
Fifty young adults aged 18 to 25, with or without DED based on the TFOS DEWS II criteria, were recruited following institutional ethics approval. Participants with any recent history of allergy or use of medications known to affect the eyes were not included. All participants completed the Ocular Surface Dry Eye Index questionnaire and a lifestyle questionnaire, including questions about screen use, contact lens wear, exercise, sleep, and self-perceived health, diet, and stress. Detailed clinical parameters of the ocular surface, tear film and meibomian glands were assessed over one year, including MMP-9 assessment with a point-of-care immunoassay.
Results :
The mean age was 19.9 ± 1.6 years, 72% were female and 56% were diagnosed with DED. A significant overlap in ocular surface signs and symptoms, particularly meibomian gland loss, was found between participants; over 90% of participants had at least one diagnostic sign, even if they didn’t have DED symptoms during the study. Contact lens wear and female sex were the most significant risk factors, while screen use and stress were the key modifiable ones. Conjunctival staining was the best clinical predictor, while the ability of MMP-9 to distinguish between DED and non-DED was inconclusive. Progression was observed mainly in the non-DED group, characterised by significant (p<0.05) increases in ocular redness and lid wiper epitheliopathy (see Table 1). Blink rate significantly increased, while non-invasive tear breakup time decreased but not significantly (p=0.081).
Conclusions :
This study has documented subtle but significant progression of ocular surface disease in a young population through changes in several key clinical parameters. The outcome suggests that young adults should be counselled for the modifiable risk factors of DED identified, regardless of whether they are symptomatic with DED.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.