Abstract
Purpose :
The prevalence of dry eye disease (DED) is thought to be increasing, but longitudinal population-based studies are lacking. We tested the hypothesis that the prevalence of DED has increased in Europe in recent years and explored age-specific changes in prevalence.
Methods :
13,099 people from the Dutch population-based Lifelines cohort and 3,871 people from the TwinsUK cohort in the United Kingdom were longitudinally assessed for DED. The Women’s Health Study (WHS) questionnaire was used to define DED, based on the presence of a clinical diagnosis and/or both dryness and irritation often or constantly. In addition to this validated primary outcome, symptoms of ocular dryness and irritation were separately assessed, as well as related factors, including ocular lubricant use, contact lens wear, and history of ocular surgery. To correct for aging of the populations, prevalence was assessed by age decades and a weighted average across age-decades was calculated. Statistical significance was tested by binomial proportion tests.
Results :
The overall prevalence of WHS-defined DED in the Dutch Lifelines cohort significantly increased from 9.6% (95%CI 9.1-10.2%) in the 2014-2017 assessment to 14.6% (95%CI 14.1-15.2%) in 2021-2023. Mean time between assessments was 7.8 years (SD 1.0 year). In the TwinsUK data, the prevalence of WHS-defined DED increased from 16.7% (95%CI 12.7-14.6%) in 2017 to 20.2% (95%CI 16.2-24.1%) in 2020. The weighted average prevalence of WHS-defined DED for each age-decade increased by 34.6% (P<0.005) between the two assessments, or around 4.4% per year, in Lifelines, while it increased by 18.9% (P<0.005), or around 6.3% per year in the TwinUK population (Figure 1). During the period, ocular dryness increased with 21.7% in the Lifelines cohort (P<0.005), while ocular irritation showed a 5.3% reduction (P<0.005), on a weighted average basis. Ocular lubricant use increased with 72.9% (P<0.005), contact lens wear increased with 30.5% (P<0.005), and history of ocular surgery increased with 11.0% (P<0.005), across all age groups in the Lifelines cohort.
Conclusions :
The prevalence of dry eye disease, and related ocular dryness symptoms, has shown an alarming increase across all age groups in two European populations in recent years. Further studies into the causes of this increase are warranted.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.