Title: Dry eye prevalence and main risk factors among undergraduate students.
Key words: Dry eye, risk factor, prevalence, young population, university, Brazil
Introduction and Purpose: Dry Eye is a common, complex and multifactorial disease of the ocular surface and tear film that results in discomfort and visual disturbance. Prevalence rates have broad variation and are mostly based on studies involving older populations. This study aims to evaluate dry eye among a sample of undergraduate students from 2 major universities in Brazil, to understand symptoms, clinical signs presentation and most associated risk factors.
Methods: Cross-sectional survey that included 2,140 students (1,649 from UNICAMP and 491 from UNIFESP). Three fields of knowledge were included:1,128 from biological; 699 from exact; and 313 from human area. All participants completed 2 self-applicable questionnaires about dry eye symptoms: Ocular Surface Disease Index (OSDI) and short questionnaire used in the Women Heath Study (WHS), both previously translated and validated to Portuguese. Dry eye symptoms were considered positive if OSDI score > 22 or reported severe symptoms and/or previous history of clinical diagnosis at WHS questionnaire. Indeed, a list of risk factors such as contact lens wear, medications, ocular surgery, and systemic disease associated to dry eye was presented. Participants who fulfilled criteria for dry eye symptoms underwent a complete clinical evaluation for signs of the disease evaporative and aqueous deficient dry eye.
Results: 2,140 participants aged 23.4±5.2 years old, 56.1% female and 43.9% male were enrolled. OSDI score was 19.4±16.2; 34.4% had OSDI had >22 and 23.5% according to WHS. Dry eye prevalence showed consistent sex differences, according OSDI scores 42.6% women and 24.0% men and with WHS 27.1% women and 18.5% men. Most common risk factors were visual display use (50.1%), less than 6 hours of sleep/day (37.0%), oral contraceptive use (21.9%), contact lens wear (16.3%) and antiallergic use (15.1%). Univariate and multivariate analysis demonstrated that female sex, contact lens wear, ocular surgery, use of electronic devices over 6 hours/day, oral contraceptive, anti-depressant, anti-allergic, sleep less than 6 hours/day as relevant related factors. Clinical evaluation demonstrated mild signs of ocular surface dysfunction, normal tear volume, tear film instability and evaporative dry eye.
Conclusions: Dry eye a prevalent condition among undergraduate students. In this Brazilian youth sample, rates were higher than data recently published, that showed in the general Brazilian population over 40 years old, the overall rate was 12.8%. However, further investigation might be addressed to better understand related risk factors and clinical presentation.
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cientifico.comau@fcm.unicamp.br
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