Prevalence of Dry Eye Disease in Mongolians at High Altitude in China: The Henan Eye Study

Abstract

Purpose: To estimate the prevalence of dry eye disease, analyze the associations between dry eye symptoms and signs, and identify the risk factors in an elderly Mongolian population at high altitude in China.

Methods: A population-based survey was conducted in 2006. A total of 2,486 Mongolians age 40 and older were selected. Symptoms of dry eye were assessed using a 6-item validated questionnaire. Dry eye disease was defined if participants reported one or more symptoms often or all the time. Positive signs included a tear-film breakup time of ≤10 seconds, a Schirmer test score of ≤ 5mm, or a fluorescein staining score ≥ 1 in one or both eyes. Presence of dry eye symptoms and positive signs were analyzed. Correlations between symptoms and signs, and risk factors were evaluated in a multivariate model.

Results: Of the 1,816 participants, 50.1% (95% confidence interval, 47.8–52.4) were symptomatic. Tear-film breakup time of ≤ 10 seconds was 37.7% (95% confidence interval, 35.5–39.9). A Schirmer test score of ≤ 5mm was 19.9% (95% confidence interval, 18.4–22.1). Fluorescein staining score ≥ 1 was 6.0% (95% confidence interval, 4.9–7.1). The correlation between dry eye symptoms and positive signs (tear-film breakup time of ≤ 10 seconds[r = 0.414, P < 0.001], Schirmer test score of ≤ 5mm [r = 0.164, P = 0.001], and fluorescein staining score ≥1 [r = 0.361, P < 0.001]) were statistically significant. Independent risk factors included increased age, age-related cataract and pterygium.

Conclusion: This study demonstrates a high prevalence rate of dry eye disease in a Mongolian population. Dry eye signs were significantly associated with dry eye symptoms.

KEYWORDS::

• Dry eye disease
• Prevalence
• Mongolians
• High altitude

ACKNOWLEDGMENTS

Funding from Jian Hua Foundation Ltd. The authors acknowledge local government officials and the workers at the six township clinics for their painstaking and enthusiastic work. The authors thank the Henan Health Bureau and Henan County Government for its organizational support and the Hong Kong Jianhua Foundation for its funding support. We are also grateful to the Mongolian participants for their generous participation in the survey.

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.