Prevalence and risk factors associated with dry eye : the Korea National Health and Nutrition Examination Survey 2010-2011

Abstract

Purpose: To assess socio-demographic and health-related risk factors associated with a dry eye in Korea. Methods: In 2010-2011, a total of 11,666 randomly selected national representative participants of the Korea National Health and Nutrition Examination Survey underwent additional ophthalmologic examinations by the Korean Ophthalmologic Society. Subjects were asked to respond a question of “Until now have you ever been diagnosed to have a dry eye before by doctor (either eye)?” with possible choices of “no” or “yes.” To make data collection more accurate, subjects were also asked to answer another question of “Until now have you ever had a dry eye symptom before, for example dryness of eye or irritation senses?” In addition to this question, the subjects were inquired to reply a subsequence question which was emphasized “by doctor”. Independent variables were divided into four categories: 1) socio-demographic factors, 2) health examination variables, 3) health behavioral risk factors and 4) variables about eye. The risk factors for dry eye were identified by using a multivariate logistic regression analysis. Results: Mean age of the 11,666 participants of age 19 or older was 49.9 years (standard error: 0.2). Overall prevalence of dry eye diagnosed by doctor were 8.0% (95% confidence interval (CI), 7.3-8.7%), and dry eye symptom were 14.4% (95% CI, 13.1~15.7%). History of any eye surgeries (adjusted Odds Ratio (aOR) =2.4, 95% CI, 2.0-2.9), female sex (aOR=2.0, 95% CI, 1.5-2.6), extremely stressful status (aOR=1.9, 95% CI, 1.2-2.9), and hypercholesterolemia of ≥240 mg/dL (aOR=1.3, 95% CI, 1.0-1.6), thyroid disease (aOR=1.7, 95% CI, 1.2~2.3) were independent risk factors for diagnosed dry eye syndrome (DES). Group with dry eye symptom showed same results with diagnosed DES. Among subjects who received an eye surgery, ptosis surgery (aOR = 4.9, 95% CI, 1.9-13.1), cataract surgery (aOR = 2.2, 95% CI, 1.7-2.9), refractive surgery (aOR=2.8, 95% CI, 2.1-3.8) compare to subject with no history of eye surgery before were more likely have dry eye. Conclusion: Ophthalmologists should be aware that past experience of ocular surgeries could be one of the most important risk factors of dry eye and have to focus on treating the dry eye problems in subjects who will receive an eye surgery or have already received. And it is important to educate the patients who were diagnosed with DES to be cautious about the risk factors and to improve their life style.