Prevalence of Dry-Eye Symptoms Versus Dry-Eye Disease in General and Refractive Surgery Populations
Narrative Responses:
Purpose
The purpose of this study was to compare the prevalence of dry eye symptoms to the prevalence of actual dry eye disease in the general and refractive surgery populations.
Methods
A post-market IRB exempt survey with informed consent was conducted on 6,553 subjects across 93 ophthalmic practice sites in the United States with 4,233 females, 2,320 males, aged 55.9±18.8 years on average. 1,326 cataract patients and 424 LASIK patients participated. In addition to basic demographics, the survey asked the subject to check all of the following symptoms that applied: fluctuating vision, contact lens discomfort, light sensitivity, watery eyes, tired eyes, redness, burning, itching, feeling of sand or grit in the eye, followed by a bilateral tear osmolarity test to confirm existence of dry eye disease, defined as ≥ 308 mOsm/L.
Results
79.2% of all subjects reported symptoms of dry eye, whereas 88.3% of cataract patients and 81.1% of LASIK patients reported at least one symptom. When the threshold was raised to > 3 symptoms, 42.8% of all subjects, 48.9% of cataract, and 42.6% of LASIK patients were symptomatic, still far higher than the epidemiological estimates of the 2007 DEWS report (between 5% and 30% of people > 50 years old). Measurements of tear osmolarity revealed that in actuality, less than half of all symptomatic subjects (42.8%), symptomatic cataract patients (48.9%), and symptomatic LASIK subjects (42.7%) had actual dry eye disease.
Conclusion
The exceedingly high prevalence of dry eye symptoms demonstrates the need for an objective, quantitative measurement of disease. Diagnosis based on symptoms alone may eliminate otherwise acceptable candidates for refractive surgery.