Original article
Impact of Dry Eye Syndrome on Vision-Related Quality of Life

https://doi.org/10.1016/j.ajo.2006.11.060Get rights and content

Purpose

To evaluate the impact of dry eye syndrome (DES) on vision-associated quality of life.

Design

Cross-sectional study.

Methods

We identified 450 participants in the Women’s Health Study (WHS) and 240 participants in the Physicians’ Health Study (PHS) and sent a supplementary questionnaire asking how much their everyday activities were limited by symptoms of dry eye and to what degree problems with their eyes limited them in reading, driving, working at the computer, their professional activity, and watching television. By design, one-third of study subjects had clinically diagnosed DES or severe symptoms and two-thirds did not. We used logistic regression to examine relationships of DES with reported problems with everyday activities in each cohort and pooled estimates using meta-analysis methods.

Results

Of the participants invited, 85% completed the supplementary questionnaire, including 135 WHS and 55 PHS participants with DES, and 250 WHS and 149 PHS participants without DES. Controlling for age, diabetes, hypertension, and other factors, those with DES were more likely to report problems with reading ([odds ratio] OR = 3.64, 95% [confidence interval] CI 2.45 to 5.40, P < .0001); carrying out professional work (OR = 3.49, 95% CI 1.72 to 7.09, P= 0.001); using a computer (OR = 3.37, 95% CI 2.11 to 5.38, P < .0001); watching television (OR = 2.84, 95% CI 1.05 to 7.74, P = .04); driving during the day (OR = 2.80, 95% CI 1.58 to 4.96, P < .0001); and driving at night (OR = 2.20, 95% CI 1.48 to 3.28, P < .0001).

Conclusions

DES is associated with a measurable adverse impact on several common and important tasks of daily living, further implicating this condition as an important public health problem deserving increased attention and resources.

Section snippets

Study population

The Women’s Health Study (WHS) was a randomized, double-masked, placebo-controlled trial among 39,876 US female health professionals (actively working or retired) ages 39 to 90 years at baseline to assess the benefits and risks of low-dose aspirin and vitamin E in the primary prevention of cardiovascular disease and cancer among healthy women.19, 20 Information on general characteristics of the study population was ascertained on annual questionnaires as has been previously reported.21 The

Study subject’s characteristics

Of the 450 WHS and 240 PHS participants selected, 85% (385 from WHS and 204 from PHS) completed the supplementary DES questionnaire and were included in this analysis. Dry eye was present in 135 women (41 who reported severe symptoms, 62 who had been diagnosed with dry eye, and 31 who had both severe symptoms and a prior diagnosis of dry eye) and 55 men (17 who reported severe symptoms, 25 with diagnosed dry eye, and 13 with both severe symptoms and a prior diagnosis of dry eye). Baseline

Discussion

Dry eye syndrome is a common problem that may often be overlooked clinically because it tends not to be a common cause of permanent visual morbidity as traditionally measured.3 However, the present study suggests that DES can have a significant impact on visual function that can diminish a person’s quality of everyday living. More specifically, the present study shows that crucial daily activities of modern living such as reading, computer use, professional work, driving, and watching

Biljana Miljanović, MD, MPH, MSc, is a Research Fellow at Harvard Medical School and the Division of Aging, Brigham, and Women’s Hospital in Boston, Massachusetts. Dr Miljanović is intrigued by questions of the consequences of modern living, e.g. with industrialized food production and dietary changes, man-made environments, medication use, and how these impact chronic diseases of aging and their consequences.

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    • Cited by (0)

    Biljana Miljanović, MD, MPH, MSc, is a Research Fellow at Harvard Medical School and the Division of Aging, Brigham, and Women’s Hospital in Boston, Massachusetts. Dr Miljanović is intrigued by questions of the consequences of modern living, e.g. with industrialized food production and dietary changes, man-made environments, medication use, and how these impact chronic diseases of aging and their consequences.

    Debra A. Schaumberg, ScD, OD, MPH, is an Associate Professor of Medicine at Harvard Medical School, Clinical Associate Scientist at the Schepens Eye Research Institute, and the Director of Ophthalmic Epidemiology, Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, Massachusetts. Dr Schaumberg principal research interests regard the roles of both environmental and genetic risk factors, and their interactions, in common eye diseases including dry eye syndrome, cataract, macular degeneration, and diabetic retinopathy.

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