Prevalence and risk factors of dry eye syndrome in a United States veterans affairs population

Am J Ophthalmol. 2011 Sep;152(3):377-384.e2. doi: 10.1016/j.ajo.2011.02.026.


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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Depressive Disorder / epidemiology
  • Drug-Related Side Effects and Adverse Reactions
  • Dry Eye Syndromes / diagnosis
  • Dry Eye Syndromes / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Sleep Apnea Syndromes / epidemiology
  • Stress Disorders, Post-Traumatic / epidemiology
  • Thyroid Diseases / epidemiology
  • United States / epidemiology
  • United States Department of Veterans Affairs
  • Veterans / statistics & numerical data*
  • Young Adult