PURPOSE To evaluate the prevalence of dry eye syndrome (DES) and its associated risk factors in a US Veterans Affairs population receiving ocular care services. DESIGN Retrospective study. METHODS SETTINGS Patients were seen in the Miami and Broward Veterans Affairs eye clinics between 2005 and 2010. PATIENTS POPULATION Patients were divided into cases and controls with regard to their dry eye status (cases = ICD9 code for DES plus dry eye therapy; controls = patients without ICD9 code plus no therapy). MAIN OUTCOME MEASURES The prevalence of DES and its associated risk factors. RESULTS A total of 16 862 patients were identified as either a dry eye case (n = 2056) or control (n = 14 806). Overall, 12% of male and 22% of female patients had a diagnosis of DES, with female gender imparting a 2.40 increased risk (95% confidence interval [CI] 2.04–2.81) over male gender. Several medical conditions were found to increase DES risk including post-traumatic stress disorder (odds ratio [OR] 1.97, 95% CI 1.75–2.23), depression (OR 1.91, 95% CI 1.73–2.10), thyroid disease (OR 1.81, 95% CI 1.46–2.26), and sleep apnea (OR 2.20, 95% CI 1.97–2.46) (all analyses adjusted for gender and age). The use of several systemic medications, including anti-depressant medications (OR 1.97, 95% CI 1.79–2.17), anti-anxiety medication (OR 1.74, 95% CI 1.58–1.91), and anti–benign prostatic hyperplasia medications (OR 1.68, 95% CI 1.51–1.86), was likewise associated with an increased risk of DES. CONCLUSIONS The prevalence of DES was found to be high in both men and women in our eye care population. This is the first study to demonstrate that in a veteran population, several diagnoses were significantly associated with DES, including post-traumatic stress disorder and depression.

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Purpose To evaluate the association between a Mediterranean dietary pattern (MeDi) and Vitamin D levels on dry eye syndrome (DES) Methods Design Cross-sectional study. Participants Male patients seen in the Miami Veterans Affairs eye clinic with normal eyelid, corneal, and conjunctival anatomy were recruited to participate in the study. Testing Patients filled out the 2005 Block Food Frequency Questionnaire (FFQ) and the Dry Eye Questionnaire 5 (DEQ5) and underwent measurement of tear film parameters. Serum level of 25-hydroxy vitamin D was also measured. Main outcome measures Association between MeDi, Vitamin D levels and dry eye syndrome. Results 247 men underwent DES testing. The mean patient age was 69 years (range 55 to 95). Using latent class analysis (LCA) to categorize the presence/absence of disease and quantify its severity, we found that adherence to the MeDi was positively associated with the risk both of having DES (odd ratio (OR) 1.25, 95% confidence interval (CI) 1.06–1.47) p=0.007) and with increasing disease severity. Vitamin D levels were not significantly associated with presence or severity of disease. However, higher levels of vitamin D were associated with decreased DES symptoms, with a −1.24 decrease in median DEQ5 score for every 10 unit increase in Vitamin D levels (p=0.01). Conclusions Adherence to the MeDi was not associated with a beneficial effect on DES. Higher vitamin D levels had a small, but favorable effect on DES symptoms.