Dry Eye

Age-related prevalence, correlation between symptoms and diagnoses, and significant associations

  • Carolyn M. Machan, OD, MSc School of Optometry & Vision Science, University of Waterloo
  • Patricia K. Hrynchak, OD, MSc, FAAO School of Optometry & Vision Science, University of Waterloo
  • Elizabeth L. Irving, OD, PhD, FAAO School of Optometry & Vision Science, University of Waterloo
Keywords: dry eye diagnosis, dry eye symptoms, meibomian gland dysfunction, prevalence, risk factors

Abstract

This study determined the prevalence of dry eye (DE) symptoms and clinical diagnosis over the age range of the human lifespan, the correlation of symptoms with diagnosis, and factors associated with DE. Data was abstracted from WatES, a retrospective file review (n=6397) of patient examinations at the University of Waterloo Optometry Clinic. The prevalence of DE symptoms and diagnosis were determined overall, in five year age groups and for individual symptoms. Using logistic regression, each symptom was analyzed for a significant association with DE diagnosis. Ocular and systemic factors, and common medications were analyzed for association with DE symptoms or diagnosis. Of all patients (0-93 years) 543 (8.5%) presented with DE symptoms. Prevalence within age groups was greatest for patients 30<35 (11.4 %) and 75<80 years (13.7 %). DE was diagnosed in 1140 patients (17.8%). Prevalence increased by 3.0% per year of age. No sex-related differences in meibomian gland dysfunction as a function of age were found. Less than half (43.5%) of symptomatic patients were diagnosed with DE. The following symptoms were associated with a DE diagnosis: dryness (OR= 7.56, 5.30-10.77 95% CI), injection (OR=3.62, 2.04-6.43 95%CI), burning/stinging/soreness (OR=2.67, 1.69-4.23 95%CI), and watery eyes/tearing (OR=1.66, 1.12-2.45 95%CI). Anterior blepharitis (OR=2.46, 2.05-2.95), being female (OR=1.24, 1.06-1.40 95%CI), contact lens wear (OR=1.34, 1.06-1.70 95%CI), and environmental allergies (OR=1.18, 1.00-1.41 95% CI) were statistically associated with a diagnosis of DE. In summary, specific presenting symptoms predicted DE diagnosis, DE was diagnosed in patients of all ages, and its prevalence increased steadily with age.

Author Biographies

Carolyn M. Machan, OD, MSc, School of Optometry & Vision Science, University of Waterloo

 

Carolyn Machan graduated with her Doctor of Optometry degree and Master of Science in Vision Science from the University of Waterloo. She has been a research associate at the University of Waterloo since 1999 including a long term continuous collaboration in the lab of Dr. E. L. Irving since 2006. Research areas of interest include epidemiology, refractive and binocular vision changes over the lifespan, ocular manifestations of diabetes, and neuro-optometry. Dr. Machan has been a clinical supervisor at the School of Optometry and Vision Science and the International Optometric Bridging Program including the Primary Care, Contact Lens, Sports Vision and Low Vision Clinics. Her current clinical interests are supervising in the Concussion and Brain Injury and Pediatrics and Special Needs Clinics. Besides many years in private practice as an optometrist, she has serve as an optometric consultation for industry.

Patricia K. Hrynchak, OD, MSc, FAAO, School of Optometry & Vision Science, University of Waterloo

Patricia Hrynchak graduated with her optometry degree from the School of Optometry and Vision Science at the University of Waterloo and obtained her MSc (Health Practitioner Teacher Education) from the University of Toronto. Her clinical focus is in Primary Care and she has worked extensively in Low Vision. Her classroom teaching includes Case Analysis and Clinical Techniques. She is the recipient of multiple teaching awards. Her research interests includes the scholarship of teaching and learning, public health and refractive development of the human visual system.

Elizabeth L. Irving, OD, PhD, FAAO, School of Optometry & Vision Science, University of Waterloo

Elizabeth Irving obtained Doctor of Optometry and Doctor of Philosophy in Vision Science degrees from the University of Waterloo. She has adjunct appointments to the Department of Ophthalmology, University of Toronto and Center for Vision Research, York University. Her clinical teaching is in the area of binocular vision. She has served as the head of binocular vision and as the School’s Interim Clinic Director. Currently, she holds a University Research Chair. Her research interests include the effects of altered visual experience on eye development using animal models, lifespan change in visual/ocular function, eye movements, binocular vision and eye care awareness.

 

Published
2019-09-04
How to Cite
Machan, C., Hrynchak, P., & Irving, E. (2019). Dry Eye. Canadian Journal of Optometry, 81(3), 9-17. https://doi.org/10.15353/cjo.v81i3.408