Patient-Reported Burden of Dry Eye Disease in the United States: Results of an Online Cross-Sectional Survey

Am J Ophthalmol. 2020 Aug:216:7-17. doi: 10.1016/j.ajo.2020.03.044. Epub 2020 Apr 8.


Purpose: To evaluate functional vision, general health status, and work productivity in individuals with and without dry eye disease (DED).

Design: Cross-sectional study.

Methods: Setting: General US population (2018).

Study population: Adults ≥18 years with (n = 1003) or without (n = 1006) self-reported DED.

Main outcome measures: All respondents completed the National Eye Institute Visual Function Questionnaire (VFQ) and the EuroQol 5-dimensions 5-levels (EQ-5D-5L). All respondents with DED completed the eye dryness score (EDS) visual analogue scale, Ocular Comfort Index (OCI), and Work Productivity and Activity Impairment (WPAI) questionnaire. Half of respondents with DED completed the Impact of Dry Eye on Everyday Life (IDEEL) questionnaire; the other half completed the Dry Eye Questionnaire 5 (DEQ-5) and Standardized Patient Evaluation of Eye Dryness (SPEED), McMonnies, and Symptom Assessment in Dry Eye (SANDE) questionnaires. All analyses were descriptive.

Results: Respondents with DED reported more comorbidities, greater exposure to adverse environmental conditions, and lower (worse) mean (standard deviation) scores on the modified Rasch-scored 28-item VFQ (VFQ-28R) total score (68.8 [11.9] vs 81.2 [12.7]) and EQ-5D-5L (0.82 [0.13] vs 0.88 [0.14]) than respondents without DED. Respondents with DED and EDS ≥60 (highest discomfort) fared worse on OCI, VFQ-28R, and WPAI than respondents with DED and EDS <40 (lowest discomfort). Similar findings were observed with IDEEL, DEQ-5, SPEED, McMonnies, and SANDE scores.

Conclusions: There is a substantial burden of DED on functional vision, general health status, and productivity; and further, these parameters appear to worsen with increasing EDS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cost of Illness
  • Cross-Sectional Studies
  • Dry Eye Syndromes / epidemiology*
  • Dry Eye Syndromes / physiopathology
  • Dry Eye Syndromes / psychology
  • Female
  • Health Status
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures
  • Public Health Surveillance
  • Quality of Life / psychology
  • Sickness Impact Profile*
  • Surveys and Questionnaires
  • United States / epidemiology
  • Vision, Ocular / physiology