Impact of dry eye syndrome on vision-related quality of life

Abstract

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.

Figures

Figure 1

Presented are the separate and pooled results for the association between DES and reported problems with selected activities of daily living, adjusted for potential confounding factors. The center of each square indicates the odds ratio (OR), and the size of the square is proportional to the percent weight each study contributed to the pooled estimate. The horizontal line bisecting each square represents the 95% confidence interval for the OR. The random-effects pooled OR and 95% CI are indicated by the unshaded diamonds. Estimates greater than one signify that subjects with DES were more likely to report having problems with that particular activity.

Figure 2

Presented are the separate and pooled findings for the association between DES and overall reported problems with activities of daily living, separately among those who did versus did not report any artificial tear use. The center of each square indicates the odds ratio (OR), and the size of the square is proportional to the percent weight each study contributed to the pooled estimate. The horizontal line bisecting each square represents the 95% confidence interval for the OR. The random-effects pooled OR and 95% CI is indicated by the unshaded diamond. Estimates greater than one signify that subjects with DES were more likely to report problems with vision-related activities of daily living.