Skip to main content
SpringerLink
Log in

Population-based study on the epidemiology of dry eye disease and its association with presbyopia and other risk factors

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Background

To investigate the incidence and prevalence of dry eye disease (DED) in Taiwan and to explore its potential risk factors.

Methods

Population-based longitudinal data from 2000 to  2013 based on Taiwan National Health Insurance Research Database were used in this study. To explore potential risks factor of interest, patients who had DED diagnosis before the exposure were excluded. Each patient from the exposure and his/her matched non-exposure controls were followed until either the diagnosis of DED or censorship. Kaplan–Meier method was used to compare the hazard of DED between cohorts. Stratified Cox proportional hazard models were applied to estimate the adjusted effect.

Results

The age-adjusted prevalence for men and women were 6.81% and 16.16%, respectively. The age–gender rate of the same period was 549 per 105 person-years. The propensity-adjusted hazard ratio of DED is 1.816 for the presbyopia versus non-presbyopia (with 95% CI = [1.737, 1.897] with p value < 0.0001).

Conclusions

The DED incidence for women peaked at age 50–74, while that for men peaked at age ≧ 75. The incidence in young people seems stable both for women and for men. While exploring the factors of DED, there is a significant association between presbyopia and DED even after matching age/gender and comorbidity conditions. Further clinical studies are needed to justify whether the corrective refractive treatment such as presbyopic glasses to treat the frequently hyperopic status of these patients could be beneficial to both dry eye and presbyopic condition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

DED:

Dry eye disease

DM:

Diabetes mellitus

LASIK:

Laser-assisted in situ keratomileusis

MGD:

Meibomian gland dysfunction

NHIRD:

National Health Insurance Research Database

OSDI:

Ocular Surface Disease Index

PK:

Penetrating keratoplasty

PS:

Propensity score

SLE:

Systemic lupus erythematosus

VDT:

Video display terminal

References

  1. Solomon JD (2010) Outcomes of corneal spherical aberration-guided cataract surgery measured by the OPD-scan. J Refract Surg 26(11):863–869

    Article  Google Scholar 

  2. Courtin R, Pereira B, Naughton G et al (2016) Prevalence of dry eye disease in visual display terminal workers: a systematic review and meta-analysis. BMJ Open 6:e009675. https://doi.org/10.1136/bmjopen-2015-009675

    Article  PubMed  PubMed Central  Google Scholar 

  3. Schaumberg DA, Sullivan DA, Buring JE, Dana MR (2003) Prevalence of dry eye syndrome among US women. Am J Ophthalmol 136(2):318–326

    Article  Google Scholar 

  4. Schaumberg DA, Dana R, Buring JE, Sullivan DA (2009) Prevalence of dry eye disease among US men: estimates from the Physicians’ Health Studies. Arch Ophthalmol 127(6):763–768. https://doi.org/10.1001/archophthalmol.2009.103

    Article  PubMed  PubMed Central  Google Scholar 

  5. Lin PU, Tsai SY, Cheng CY, Liu JH, Chou P, Hsu WM (2003) Prevalence of dry eye among an elderly Chinese population in Taiwan: The Shihpai Eye Study. Ophthalmology 110:1096–1101

    Article  Google Scholar 

  6. Yen JC, Hsu CA, Li YC et al (2015) The prevalence of dry eye syndrome’s and the likelihood to develop Sjögren’s syndrome in Taiwan: a population-based study. Int J Environ Res Public Health 12:7647–7655. https://doi.org/10.3390/ijerph120707647

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Lee AJ, Lee J, Saw SM et al (2002) Prevalence and risk factors associated with dry eye symptoms: a population based study in Indonesia. Br J Ophthalmol 86:1347–1351

    Article  CAS  Google Scholar 

  8. Ţuru L, Alexandrescu C, Stana D, Tudosescu R (2012) Dry eye disease after LASIK. J Med Life 5(1):82–84

    PubMed  PubMed Central  Google Scholar 

  9. Yilmaz U, Gokler ME, Unsal A (2015) Dry eye disease and depression-anxiety-stress: a hospital-based case control study in Turkey. Pak J Med Sci 31(3):626–631. https://doi.org/10.12669/pjms.313.7091

    Article  PubMed  PubMed Central  Google Scholar 

  10. Chen CH, Yang TY, Lin CL et al (2016) Dry eye syndrome risks in patients with fibromyalgia: A National Retrospective Cohort Study. Medicine 95(4):e2607

    Article  Google Scholar 

  11. Galor A, Feuer W, Lee JD et al (2011) Prevalence and risk factors of dry eye syndrome in a United States veterans affairs population. Am J Ophthalmol 152(3):377–384. https://doi.org/10.1016/j.ajo.2011.02.026

    Article  PubMed  PubMed Central  Google Scholar 

  12. Denoyer A et al (2015) Dry eye disease after refractive surgery: comparative outcomes of small incision lenticule extraction versus LASIK. Ophthalmology 122:669–676

    Article  Google Scholar 

  13. Rosenbaum PR, Rubin DB (1984) Reducing bias in observational studies using subclassification on the propensity score. J Am Stat Assoc 79:516–524

    Article  Google Scholar 

  14. Kaido M, Kawashima M, Ishida R, Tsubota K (2017) Severe symptoms of short tear break-up time dry eye are associated with accommodative microfluctuations. Clinic Ophthalmol 11:861–869

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Taiwan National Health Research Institute for the approval of using the National Health Insurance Research Data.

Author information

Authors and Affiliations

  1. Far Eastern Memorial Hospital, Taipei, Taiwan, ROC

    Elsa L. C. Mai

  2. Yuanpei University of Medical Technology, Hsinchu, Taiwan, ROC

    Chih-cheng Lin & Meiling Chen

  3. National Changhua University of Education, Changhua, Taiwan, ROC

    Iebin Lian & Renhao Liao

  4. Taipei Nobel Eye Clinic, Taipei, Taiwan, ROC

    Chaokai Chang

Authors
  1. Elsa L. C. Mai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chih-cheng Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Iebin Lian
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Renhao Liao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Meiling Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chaokai Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

EM conceived the study and drafted the manuscript, CL participated in the design of the study and coordination, IL coordinated the statistical analysis and interpreted the results, RL and CM carried out the data management and analysis, and CC carried out the epidemiological studies and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Chaokai Chang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Availability of data and materials

Data used in analysis are available upon request to corresponding author.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All personal identification numbers in NHIRD used in this study were encrypted by conversion into scrambled numbers before data processing. Because the database used consists of de-identified secondary data released for research purposes, this study was exempt from full review by the Institutional Review Board National Changhua University of Education (No. NCUEREC-103-211).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (XLSX 30 kb)

Appendix

Appendix

See Table 3.

Table 3 ICD-9 codes for potential confounders (in alphabetic order)
Full size table

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mai, E.L.C., Lin, Cc., Lian, I. et al. Population-based study on the epidemiology of dry eye disease and its association with presbyopia and other risk factors. Int Ophthalmol 39, 2731–2739 (2019). https://doi.org/10.1007/s10792-019-01117-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-019-01117-5

Keywords

Search

Navigation