The prevalence and determinants of dry eye disease amongst people living in Kwa-Mhlanga

Abstract

Dry eye disease (DED) is defined as a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolality of the tear film and inflammation of the ocular surface. DED is one of the most frequently established diagnoses in ophthalmology and represents a growing public health concern, with consequences that remain widely underestimated. There is variability of clinical manifestations and diagnostic criteria which leads to poor correlation between clinical signs and symptoms, therefore resulting in difficulties to assess prevalence of DED despite an improved understanding of pathogenic factors of acquired DED. However, its prevalence has been reported to range from 74% to 33% worldwide and the current study aimed to investigate the prevalence of DED and its determinants amongst people consulting at Focus Optometrists in Kwa-Mhlanga Township in Mpumalanga Province. Methodology: The current study was quantitative in nature and it followed a cross-sectional descriptive design to address the research question. The study population were people consulting at Focus Optometrists in Kwa-Mhlanga Township in Mpumalanga Province in which two standardized optometry diagnostic tests (Schimer test and the tear film break up time) were used for data collection coupled with a comprehensive case history which was taken for all participants. Data analysis was done using the STATA statistical software version 12 for Windows (STATA Corporation, College Station, Texas). Frequency tables were used to make comparisons between groups for continuous and categorical variables using student t-test, and chi-square test. P-value less than 0.05 at 95% confidence level were regarded as significant. Results: A total of 236 participants were recruited and the mean age of the participants was 39.7 in which majority of participants were females and there was a statistical significance difference in age groups of both males and females at p-value=0.011. Majority of the participants have reported to have experience of sensitivity to light vi and foreign body sensation sometimes. The poor vision and blurred vision have been reported by majority of participants sometimes and the prevalence of dry eye disease was found to be 80.9% and the risk of the dry eye disease in the current study was found significantly increasing with old age. Those who were older (35 years above) were 4.2 times more likely to develop dry eye disease at p-value <0.001 as compared to young participants. Female gender was found not to be protective of developing dry eye disease in the current and participants who were single, having secondary and education qualifications were more likely to develop dry eye disease. Participants with ocular conditions, systemic disease, surgery and those with high blood pressure were more likely to develop dry disease Conclusion: The prevalence of dry eye disease in the current study was found to be very high and therefore, patients coming to the clinic from the age of 40 with underlying systemic diseases should be screened for dry eyes. Dry eye disease can be a major contributor of refractive error in the visual systems and or can also be a sign or a symptom of hormonal or related ocular or systemic disease. More eye care awareness should be done at primary eye care level to detect the cause or to eliminate future associated symptoms.