A clinical study of prevalence, risk factors and management of dry eye at regional eye hospital

Abstract

Background and Objectives: Dry eye is a common multifactorial disorder of tear film resulting in ocular discomfort and tear-film instability with potential damage to ocular surface, due to decreased tear production or increased tear evaporation. It progressively increases in severity and if not detected may lead to sight threatening complications. This study was undertaken to study the prevalence, risk factors and diagnostic tests for dry eye. Methods: This study was conducted in Ophthalmology OPD at Regional Eye Hospital and attached to kakatiya Medical College, Warangal from September 2017 to August 2019. 300 patients were enrolled in this study. Occupation, smoking history and other systemic co-morbidities were documented. They were given OSDI questionnaire and subjected to four tests (Schirmer’s test, TBUT, Rose Bengal test, Fluorescein staining). If ≥2 tests were positive, the patients were diagnosed as dry eye. All dry eye patients were treated with tear substitutes and those with MGD were treated with tablet Doxycycline 100mg BD. Results and Conclusion: Dry eye prevalence was found to be 46.7%. It was more prevalent in females >40 years of age (60.4%). The prevalence increased with increasing age more among patients >50 years of age (49.3%) followed by age group 30-39 years (35%). Patients with outdoor jobs such as farmers, labourers had higher percentage of dry eye (50%) followed by office workers (22.1%). 70% of the dry eye patients had refractive error with or without history of spectacle use (p<0.00). It was more among the smokers than non-smokers. Patients having diabetes mellitus had higher prevalence of dry eye (29.3%) (p<0.00). TBUT showed high sensitivity and specificity while Schirmer’s test was highly specific, followed by other tests. Based on OSDI scores, most patients had moderate dry eye symptoms. During follow-up there was improvement in OSDI scores while no significant improvement in diagnostic test scores.