Dry Eye Symptoms Damage Overall Quality of Life

Dry eye symptoms are independently associated with poor health-related quality of life.

Dry eye symptoms appear to be independently associated with poor general health-related quality of life (HRQOL), with the association being driven by factors such as reduced visual functioning and recent falls, a report published in the British Journal of Ophthalmology shows.

Researchers conducted a cross-sectional study to evaluate the association of dry eye symptoms with HRQOL in the population of Singapore and investigate which factors might mediate any association.

The team defined the presence of dry eye symptoms as experiencing 1 or more of 6 symptoms either often or all the time. They assessed generic HRQOL using the EuroQOL-5 dimensions (EQ-5D) utility instrument and converted the raw scores to UK time trade-off (TTO) values. They also evaluated visual functioning with the overall score from the Visual Functioning Questionnaire. They tested the association between dry eye symptoms and HRQOL using a statistical model adjusted for demographic and socioeconomic factors, comorbidities, and systemic and ocular examination results. 

Factors that mediate the association between dry eye and [quality of life] include visual functioning and the presence of recent falls.

A total of 7707 participants (51% women, 49% men) were included in the study. Using the statistical model adjusted for relevant factors, the researchers demonstrated that participants with dry eye symptoms had significantly lower HRQOL than those without symptoms (difference in EQ-5D TTO, -0.062; 95% CI, -0.073 to -0.050; P <.001). 

Among the dry eye symptoms considered, they found that the inability to open eyes had the largest impact on HRQOL (difference in EQ-5D TTO, -0.101; 95% CI, -0.161 to -0.042; P <.001), followed by a “sandy” sensation (difference in EQ-5D TTO, -0.089; 95% CI, -0.121 to -0.058; P <.001), a “burning” sensation (difference in EQ-5D TTO, -0.070; 95% CI, -0.105 to -0.036; P <.001), red eyes (difference in EQ-5D TTO, -0.059; 95% CI, -0.082 to -0.036; P <.001), a “dry” sensation (difference in EQ-5D TTO, -0.058; 95% CI, -0.072 to -0.044; P<.001) and crusting of the eyelids (difference in EQ-5D TTO, -0.040 (95% CI -0.071 to -0.008; P =.014). 

The researchers also discovered that reduced visual functioning and the presence of recent falls indirectly accounted for 8.63% (95% CI, 4.98%-14.5%) and 2.93% (95% CI, 0.04%-5.68%), respectively, of the relationship between dry eye and HRQOL.

“Factors that mediate the association between dry eye and [quality of life] include visual functioning and the presence of recent falls,” the researchers wrote. “Our results suggest that efforts to reduce severity of [dry eye symptoms] are essential to optimize patients’ overall functioning and well-being.” 

Limitations of the study included a no use of specific ocular examination for the diagnosis of dry eye syndrome, inability to draw causal relationships using a cross-sectional study design, participant self-reporting of many of the variables included in the statistical model, and no use of dedicated anxiety and depression questionnaires.

References:

Lim EWL, Chong CCY, Nusinovici S, et al. Relationship between dry eye symptoms and quality of life: associations and mediation analysis. Bri J Ophthalmol. Published online August 8, 2022 doi:10.1136/bjo-2022-321246