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Estimates of dry eye disease in Saudi Arabia based on a short questionnaire of prevalence, symptoms, and risk factors: The Twaiq Mountain Eye Study I

Published:October 06, 2022DOI:https://doi.org/10.1016/j.clae.2022.101770

      Abstract

      Purpose

      To estimate the prevalence and associated risk factors of dry eye disease (DED) among the citizens of Saudi Arabia.

      Methods

      A cross-sectional prevalence survey was administered to 4066 healthy adults from the five main regions of Saudi Arabia. Initial estimates of the prevalence and associated risk factors of DED were calculated for the general population and then stratified by demographic characteristics such as age, sex, and location. DED was assessed by a short, validated dry-eye questionnaire.

      Results

      The overall prevalence of DED was 49.5 % (n = 2016), including 33.1 % (n = 1347) of participants who reported a previous DED diagnosis and 16.4 % (n = 669) who reported severe symptoms; 14.7 % reported severe symptoms and a previous DED diagnosis (n = 598). The DED prevalence among men was 49.8 % (n = 1005) compared with 50.2 % (n = 1011) for women. The multivariate model analysis confirmed the increased prevalence of DED in women (OR 1.48; 95 % CI 1.30–1.88), those ≥60 years of age (OR 1.99; 95 % CI 1.60–2.81), those who had undergone refractive surgery (OR 1.79; 95 % CI 1.50–2.59), those having undergone acne treatment (OR 1.51; 95 % CI 1.34–1.97), contact lens wearers (OR 1.77; 95 % CI 1.40–2.48), those having taken antiallergy drugs (OR 2.23; 95 % CI 1.55–2.78) or antidepressants (OR 1.60; 95 % CI 1.14–2.44), and those who reported computer use of >6 h per day (OR 1.66; 95 % CI 1.41–2.52).

      Conclusion

      Dry eye is a common disease among the Saudi Arabian population. Prevalence is found to be high and vary significantly across the country. DED could be attributed to dry weather, low annual rainfall, low humidity, widespread use of air conditioners, air pollution, high temperature, and exposure to sunlight.

      Keywords

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      References

        • Craig J.P.
        • Nichols K.K.
        • Akpek E.K.
        • Caffery B.
        • Dua H.S.
        • Joo C.K.
        • et al.
        TFOS DEWS II definition and classification report.
        Ocular Surface. 2017; 15: 276-283
        • Stapleton F.
        • Alves M.
        • Bunya V.Y.
        • Jalbert I.
        • Lekhanont K.
        • Malet F.
        • et al.
        Tfos dews ii epidemiology report.
        Ocular Surface. 2017; 15: 334-365
        • Miljanović B.
        • Dana R.
        • Sullivan D.A.
        • Schaumberg D.A.
        Impact of dry eye syndrome on vision-related quality of life.
        Am J Ophthalmol. 2007; 143: 409-415
        • Uchino M.
        • Schaumberg D.A.
        Dry eye disease: impact on quality of life and vision.
        Curr Ophthalmol Rep. 2013; 1: 51-57
        • Jones L.
        • Downie L.E.
        • Korb D.
        • Benitez-del-Castillo J.M.
        • Dana R.
        • Deng S.X.
        • et al.
        TFOS DEWS II management and therapy report.
        Ocular Surface. 2017; 15: 575-628
        • Wan K.H.
        • Chen L.J.
        • Young A.L.
        Efficacy and safety of topical 0.05% cyclosporine eye drops in the treatment of dry eye syndrome: a systematic review and meta-analysis.
        Ocular Surface. 2015; 13: 213-225
        • Craig J.P.
        • Nelson J.D.
        • Azar D.T.
        • Belmonte C.
        • Bron A.J.
        • Chauhan S.K.
        • et al.
        TFOS DEWS II report executive summary.
        Ocular Surface. 2017; 15: 802-812
        • Miljanovic B.
        • Trivedi K.A.
        • Dana M.R.
        • Gilbard J.P.
        • Buring J.E.
        • Schaumberg D.A.
        Relation between dietary n− 3 and n− 6 fatty acids and clinically diagnosed dry eye syndrome in women.
        Am J Clin Nutrit. 2005; 82: 887-893
        • Schaumberg D.A.
        • Buring J.E.
        • Sullivan D.A.
        • Dana M.R.
        Hormone replacement therapy and dry eye syndrome.
        JAMA. 2001; 286: 2114-2119
        • Schaumberg D.A.
        • Sullivan D.A.
        • Buring J.E.
        • Dana M.R.
        Prevalence of dry eye syndrome among US women.
        Am J Ophthalmol. 2003; 136: 318-326
        • Schaumberg D.A.
        • Dana R.
        • Buring J.E.
        • Sullivan D.A.
        Prevalence of dry eye disease among US men: estimates from the Physicians' Health Studies.
        Arch Ophthalmol. 2009; 127: 763-768
        • Castro J.S.
        • Selegatto I.B.
        • Castro R.S.
        • Miranda E.
        • de Vasconcelos J.P.
        • De Carvalho K.M.
        • et al.
        Prevalence and risk factors of self-reported dry eye in Brazil using a short symptom questionnaire.
        Sci Rep. 2018; 8: 1-9
        • Vehof J.
        • Kozareva D.
        • Hysi P.G.
        • Hammond C.J.
        Prevalence and risk factors of dry eye disease in a British female cohort.
        Br J Ophthalmol. 2014; 98: 1712-1717
        • Malet F.
        • Le Goff M.
        • Colin J.
        • Schweitzer C.
        • Delyfer M.N.
        • Korobelnik J.F.
        • et al.
        Dry eye disease in French elderly subjects: the Alienor Study.
        Acta Ophthalmol. 2014; 92: e429-e436
        • Na K.S.
        • Han K.
        • Park Y.G.
        • Na C.
        • Joo C.K.
        Depression, stress, quality of life, and dry eye disease in Korean women: a population-based study.
        Cornea. 2015; 34: 733-738
        • Tan L.L.
        • Morgan P.
        • Cai Z.Q.
        • Straughan R.A.
        Prevalence of and risk factors for symptomatic dry eye disease in Singapore.
        Clin Exp Optometry. 2015; 98: 45-53
        • McCarty C.A.
        • Bansal A.K.
        • Livingston P.M.
        • Stanislavsky Y.L.
        • Taylor H.R.
        The epidemiology of dry eye in Melbourne, Australia.
        Ophthalmol. 1998; 105: 1114-1119
        • Lee A.J.
        • Lee J.
        • Saw S.M.
        • Gazzard G.
        • Koh D.
        • Widjaja D.
        • et al.
        Prevalence and risk factors associated with dry eye symptoms: a population based study in Indonesia.
        Br J Ophthalmol. 2002; 86: 1347-1351
        • Lin P.Y.
        • Tsai S.Y.
        • Cheng C.Y.
        • Liu J.H.
        • Chou P.
        • Hsu W.M.
        Prevalence of dry eye among an elderly Chinese population in Taiwan: the Shihpai Eye Study.
        Ophthalmology. 2003; 110: 1096-1101
        • Jie Y.
        • Xu L.
        • Wu Y.Y.
        • Jonas J.B.
        Prevalence of dry eye among adult Chinese in the Beijing Eye Study.
        Eye. 2009; 23: 688-693
        • Viso E.
        • Rodriguez-Ares M.T.
        • Gude F.
        Prevalence of and associated factors for dry eye in a Spanish adult population (the Salnes Eye Study).
        Ophthalmic Epidemiol. 2009; 16: 15-21
        • Uchino M.
        • Nishiwaki Y.
        • Michikawa T.
        • Shirakawa K.
        • Kuwahara E.
        • Yamada M.
        • et al.
        Prevalence and risk factors of dry eye disease in Japan: Koumi study.
        Ophthalmology. 2011; 118: 2361-2367
        • Ahn J.M.
        • Lee S.H.
        • Rim T.H.T.
        • Park R.J.
        • Yang H.S.
        • Kim T.i.
        • et al.
        Prevalence of and risk factors associated with dry eye: The Korea National Health and Nutrition Examination Survey 2010–2011.
        Am J Ophthalmol. 2014; 158: 1205-1214.e7
        • Sherry A.
        • Aridi M.
        • Ghach W.
        Prevalence and risk factors of symptomatic dry eye disease in Lebanon.
        Contact Lens Anterior Eye. 2020; 43: 355-358
        • Bakkar M.M.
        • Shihadeh W.A.
        • Haddad M.F.
        • Khader Y.S.
        Epidemiology of symptoms of dry eye disease (DED) in Jordan: A cross-sectional non-clinical population-based study.
        Contact Lens Anterior Eye. 2016; 39: 197-202
        • Alkabbani S.
        • Jeyaseelan L.
        • Rao A.P.
        • Thakur S.P.
        • Warhekar P.T.
        The prevalence, severity, and risk factors for dry eye disease in Dubai–a cross sectional study.
        BMC Ophthalmol. 2021; 21: 1-7
        • Shanti Y.
        • Shehada R.
        • Bakkar M.M.
        • Qaddumi J.
        Prevalence and associated risk factors of dry eye disease in 16 northern West bank towns in Palestine: a cross-sectional study.
        BMC Ophthalmol. 2020; 20: 1-8
        • Alshamrani A.A.
        • Almousa A.S.
        • Almulhim A.A.
        • Alafaleq A.A.
        • Alosaimi M.B.
        • Alqahtani A.M.
        • et al.
        Prevalence and risk factors of dry eye symptoms in a Saudi Arabian population, Middle East.
        Afr J Ophthalmol. 2017; 24: 67
        • Bukhari A.
        • Ajlan R.
        • Alsaggaf H.
        Prevalence of dry eye in the normal population in Jeddah, Saudi Arabia.
        Orbit. 2009; 28: 392-397
        • Abusharha A.A.
        • Pearce E.I.
        The effect of low humidity on the human tear film.
        Cornea. 2013; 32: 429-434
        • Abusharha A.A.
        • Pearce E.I.
        • Fagehi R.
        Effect of ambient temperature on the human tear film.
        Eye Contact Lens: Sci Clin Practice. 2016; 42: 308-312
      1. Oden NL, Lilienfeld DE, Lemp MA, Nelson JD, Ederer F. Sensitivity and specificity of a screening questionnaire for dry eye. In Lacrimal Gland, Tear Film, and Dry Eye Syndromes 2 1998 (pp. 807–820). Springer, Boston, MA.

        • Gulati A.
        • Sullivan R.
        • Buring J.E.
        • Sullivan D.A.
        • Dana R.
        • Schaumberg D.A.
        Validation and repeatability of a short questionnaire for dry eye syndrome.
        Am J Ophthalmol. 2006; 142: 125-131
        • Galor A.
        • Feuer W.
        • Lee D.J.
        • Florez H.
        • Carter D.
        • Pouyeh B.
        • et al.
        Prevalence and risk factors of dry eye syndrome in a United States veterans affairs population.
        Am J Ophthalmol. 2011; 152: 377-384
        • Okumura Y.
        • Inomata T.
        • Iwata N.
        • Sung J.
        • Fujimoto K.
        • Fujio K.
        • et al.
        A review of dry eye questionnaires: measuring patient-reported outcomes and health-related quality of life.
        Diagnostics. 2020; 10: 559
      2. Alves M, Reinach PS, Paula JS, Vellasco e Cruz AA, Bachette L, Faustino J, Aranha FP, Vigorito A, de Souza CA, Rocha EM. Comparison of diagnostic tests in distinct well-defined conditions related to dry eye disease. PloS One. 2014;9(5):e97921.

        • Sahai A.
        • Malik P.
        Dry eye: prevalence and attributable risk factors in a hospital-based population.
        Indian J Ophthalmol. 2005; 53: 87-91
        • Moss S.E.
        • Klein R.
        • Klein B.E.
        Prevalence of and risk factors for dry eye syndrome.
        Arch Ophthalmol. 2000; 118: 1264-1268
        • Akkaya S.
        • Atakan T.
        • Acikalin B.
        • Aksoy S.
        • Ozkurt Y.
        Effects of long-term computer use on eye dryness.
        Northern Clin Istanbul. 2018; 5: 319
        • Almutairi A.H.
        • Alalawi B.S.
        • Badr G.H.
        • Alawaz R.A.
        • Albarry M.
        • Elbadawy H.M.
        Prevalence of dry eye syndrome in association with the use of contact lenses in Saudi Arabia.
        BMC Ophthalmol. 2021; 21: 1-7
        • Bazeer S.
        • Jansonius N.
        • Snieder H.
        • Hammond C.
        • Vehof J.
        The relationship between occupation and dry eye.
        Ocular Surface. 2019; 17: 484-490
        • Schein S.
        • Muño B.
        • Tielsch J.M.
        • Bandeen-Roche K.
        • West S.
        Prevalence of dry eye among the elderly.
        Am J Ophthalmol. 1997; 124: 723-728
        • Viso E.
        • Rodríguez-Ares M.T.
        • Abelenda D.
        • Oubina B.
        • Gude F.
        Prevalence of asymptomatic and symptomatic meibomian gland dysfunction in the general population of Spain.
        Invest Ophthalmol Vis Sci. 2012; 53: 2601-2606
        • Siak J.J.
        • Tong L.
        • Wong W.L.
        • Cajucom-Uy H.
        • Rosman M.
        • Saw S.M.
        • et al.
        Prevalence and risk factors of meibomian gland dysfunction: the Singapore Malay eye study.
        Cornea. 2012; 31: 1223-1228
        • Asiedu K.
        • Kyei S.
        • Boampong F.
        • Ocansey S.
        Symptomatic dry eye and its associated factors: a study of university undergraduate students in Ghana.
        Eye Contact Lens. 2017; 43: 262-266
        • Kobia-Acquah E.
        • Ankamah-Lomotey S.
        • Owusu E.
        • Forfoe S.
        • Bannor J.
        • Koomson J.A.
        • et al.
        Prevalence and associated risk factors of symptomatic dry eye in Ghana: a cross-sectional population-based study.
        Contact Lens Anterior Eye. 2021; 44101404
        • Wolffsohn J.S.
        • Arita R.
        • Chalmers R.
        • Djalilian A.
        • Dogru M.
        • Dumbleton K.
        • et al.
        TFOS DEWS II diagnostic methodology report.
        Ocular Surface. 2017; 15: 539-574
        • Bron A.J.
        • Tomlinson A.
        • Foulks G.N.
        • Pepose J.S.
        • Baudouin C.
        • Geerling G.
        • et al.
        Rethinking dry eye disease: a perspective on clinical implications.
        Ocular Surface. 2014; 12: S1-S31
        • Nichols K.K.
        Patient-reported symptoms in dry dye disease.
        Ocular Surface. 2006; 4: 137-145