Associations between dry eye symptoms with tear film stability, volume, and osmolarity in a sample of young adults in Kuala Lumpur

Abstract

Context: Dry eyes (DE) are common ocular problems and any abnormalities in tear film are a concern to eye care practitioners. However, the association between DE symptoms with clinical tests is controversial. Aim:This study aims to investigate the associations between DE symptoms with tear film stability, volume, and osmolarity in a sample of young adults living in Kuala Lumpur. Methodology: A total of 107 healthy young adults, 35 males and 72 females participated in this study with a mean age of 23.06 ± 2.63 years. DE symptoms were screened using McMonnies DE questionnaire (MDEQ); tear stability was evaluated using tear break-up time test (TBUT); tear volume was measured using phenol red thread test (PRT); and tear osmolarity was measured with micro osmometer. The MDEQ score classified 36 subjects as having DE and 71 as non-DE (NDE). Results: Mean score for DE was 16.49 ± 1.74 and 7.23 ± 3.09 for NDE. Mean TBUT for DE and NDE was 4.76 ± 1.58 s and 5.69 ± 1.61 s, respectively. Mean PRT was 7.97 ± 5.60 mm for DE and 12.59 ± 5.70 mm for NDE. Mean tear osmolarity for DE and NDE was 322.42 ± 36.94 Osm/L and 286.35 ± 21.31Osm/L accordingly. Analysis using independent t-test showed a significant difference in TBUT and osmolarity between two groups (P < 0.05). Mann–Whitney sum rank test shown that there were significant differences in PRT measurement between two group (P = 0.00). Significant correlations were noted between MDEQ score with tear osmolarity (r = 0.42, n = 107, P = 0.00), PRT (r = −0.36, n = 107, P = 0.00) and TBUT (r = −0.28, n = 107, P = 0.00). Conclusion: This study demonstrated that significant associations between DE symptoms with TBUT, PRT, and tear osmolarity. MDEQ should be considered by eye care practitioners to confirm the diagnosis of dry eye.