A Questionnaire-Based Assessment of Symptoms Associated with Tear Film Dysfunction and Lid Margin Disease in an Asian Population

Abstract

Purpose: To study the prevalence, associated factors and impact of symptomatic dry eye in an Asian population. Methods: A population based survey of eye diseases in 3,280 (78.7% response rate) Malay persons aged 40–80 selected from designated areas in southwestern Singapore. Participants were administered a standardized dry eye questionnaire consisting of 6 questions on symptoms, and had a comprehensive systemic and ocular examination. Symptoms of tear film dysfunction (STFD) was defined as one or more self-reported symptoms that were frequently present (ranked often or all the time). Results: The prevalence rate of STFD was 6.5% (95% confidence interval [CI]: 5.7, 7.4). The prevalence was significantly higher in men compared to women (8.2% and 4.9%, respectively; p < 0.001) and decreased with age in men (p = 0.002) but not in women (p = 0.101). After adjusting for age, gender, nature of work (outdoor/indoor), and housing type, factors significantly associated with STFD were cigarette smoking (odds ratio [OR] 1.77, 95% CI: 1.17–2.66), thyroid disease (OR 2.58; 95% CI: 1.29–5.18) and higher income (OR 1.74; 95% CI: 1.13–2.68). STFD were associated with self-reported difficulty in performing daily activities (work, family and leisure related) (p = 0.006). Conclusion: STFD are present in 6.5% of Singapore Malay adults and is associated with cigarette smoking, presence of thyroid disease and a reduced visual function-related quality of life.