Prevalence and Associated Risk Factors of Dry Eye Disease Among Children and Adults in Saudi Arabia: A Cross-Sectional Study

Abstract

Background: Dry eye disease (DED) is characterized by loss of homeostasis of the tear film or failure to produce sufficient amounts of tears to moisturize the eyes. The condition has been associated with several preventable risk factors.Objective: The objective of this study is to calculate the prevalence of dry eye and determine the associated risk factors among adults and children in Saudi Arabia.Methods: This is a cross-sectional study targeting all Saudi populations, including all the regions of Saudi Arabia. The Ocular Surface Disease Index (OSDI) and the five-item Dry Eye Questionnaire (DEQ-5) were used for data collection. Data were collected using an online form that was distributed through social media.Results: A total of 541 responses were analyzed. The OSDI scores showed that females represented 70.9%, and the age group of 20-40 years represented 59.7%. The prevalence of DED, including all severity levels, was 74.9%. The distribution across levels was as follows: mild cases at 26.2%, moderate cases at 18.2%, and severe at 30.4%. On the other hand, DEQ-5 has shown a prevalence of 37% among the pediatric age group. Several risk factors have been significantly associated with adults' dry eye, including low humidity (P-value=0.002), reading, driving, or watching electronic screens for extended durations (P-value=0.019), autoimmune diseases (P-value=0.033), and undergoing eye procedures (P-value-0.013). Conclusion:The current study reports a high prevalence rate of dry eyes among the Saudi population. Reading, driving, and using electronic screens for an extended period were found to be associated with the severity of DED. Prospective studies should focus on the epidemiology of the disease, which will provide evidence for better preventive and therapeutic measures.

Prevalence and Risk Factors of Dry Eye Disease in Association With the Increased Use of Electronic Devices Among University Students in Western Saudi Arabia

“…Using the OSDI questionnaire, the prevalence of DED in this study was 74.6%, consisting of mild (21.1%), moderate (14.9%), and severe (38.6%) levels (mean OSDI score: 30.4; SD 23.6). Consistent with our findings, a study published by Alrabghi et al [29] found a prevalence of DED of 74.9%, with severe cases detected in 30.4%. This has been corroborated by the study of Choi et al [30], with a prevalence of 78.1%, compromising mild, moderate, and severe cases detected in 25.8%, 18.7%, and 33.5%, respectively.…”

“…The behavior when using DD could increase the DED-related symptoms such that the longer the use of DD, the greater the risk for DED symptoms. Consistent with this scenario, several studies documented an association between prolonged use of electronic devices and DED [29,30,32,36,37]. However, this is not the case in a study by Aljammaz et al [38], as they found no significant association between DED and the number of hours in front of the screen device, along with age, family history of DED, and history of corrective eye surgery.…”

Appropriateness of Questionnaires for the Diagnosis and Monitoring Treatment of Dry Eye Disease

“…Recent papers comparing these two questionnaires (OSDI and DEQ-5) reported a correlation of 0.649 in a population of 392 in Ghana (but over one-third were asymptomatic of dry eye) [ 21 ], and a correlation of 0.566 in a population of 101 in India [ 22 ]. This leads to uncertainty in this element of dry eye disease diagnosis in some patients [ 23 , 24 ]. The Symptom Assessment iN Dry Eye (SANDE) questionnaire, with its global assessment of dry eye frequency and severity reported on a visual analogue scale, also provides a sensitive (68%) and specific (94%) test in combination with non-invasive tear breakup time as an alternative to assessing the full TFOS DEWS II recommended diagnosis of dry eye disease [ 25 ].…”