RESUMO
PURPOSE: Anecdotal evidence suggests that eyelid disorders are common, although estimates of prevalence vary. The current study determines the prevalence of eyelid disorders, meibomian gland dysfunction (MGD) and related diseases (specifically ocular surface disease) in a population of patients presenting for routine ophthalmologic consultations. METHODS: This cross-sectional epidemiologic survey evaluated patients presenting for routine ophthalmic visits. During the consultation an ophthalmologist completed a questionnaire, and each patient underwent an ophthalmic examination and completed a quality of life questionnaire. RESULTS: Three hundred forty-nine ophthalmologists, recruited from 11 countries, provided data on 6525 patients. Patients were predominantly females (61.6%). The mean age of the study population was 57.0 ± 17.6 years. Eyelid disorders were diagnosed in 5109 (78.3%) patients and were statistically associated with: atopic dermatitis, seborrheic dermatitis, dry eye, age-related macular degeneration, diabetes, cataract, allergy and MGD (P < 0.05, all associations). Eyelid abnormalities were identified in 59.6% of patients; conjunctival or corneal abnormalities were observed in 64.9% and 28.1% of patients, respectively. MGD was diagnosed in 54.3% patients and was statistically significantly associated with the presence of eyelid disorders and eyelid margin abnormalities (P < 0.001, both comparisons). Dry eye was diagnosed in 61.8% of patients. Concurrent dry eye and MGD were present in 67.6% of patients. Most patients reported some degree of impaired vision and daily/work activities related to dry eye. Impact on contact lens usage, emotions and quality of sleep was also reported. The effects on daily life were associated with the presence of MGD. CONCLUSION: In conclusion, eyelid disorders were highly prevalent in this 'real-world' population of patients from ophthalmology clinics. Routine ophthalmologic consultations provide an opportunity to improve patient quality of life and to modify topical therapy in patients who may be predisposed to eyelid disorders.
RESUMO
PURPOSE: To assess the prevalence and severity of dry-eye disease in patients with myopia being evaluated for laser in situ keratomileusis. SETTING: Nine ophthalmology centers in Russia. DESIGN: Prospective noninterventional cross-sectional study. METHODS: The assessments included the Schirmer I test, tear breakup time (TBUT), lissamine green and fluorescein staining (Oxford grading scheme), Ocular Surface Disease Index (OSDI) questionnaire, and Dry Eye Workshop (DEWS) dry-eye severity grading. RESULTS: The study comprised 400 patients with myopia (mean age 29.7 years); 145 (36.2%) wore contact lenses, and 81 (20.2%) used topical dry-eye medication. The mean Schirmer test score was 15.2 mm; 36.5% of patients had evidence of tear-volume deficiency (Schirmer score ≤10 mm). The mean TBUT was 11.7 seconds; 10.1% of patients had tear-film instability (TBUT <5 seconds). Conjunctival (lissamine green) staining intensity was categorized as minimal or greater (grade ≥1) in 62.3% of patients and mild or greater (grade ≥2) in 22.8% of patients. The mean OSDI score was 20.4, indicating mild ocular disability. Dry-eye severity (DEWS grading) was mild/episodic in 66.2%, moderate in 29.5%, and severe in 4.3% of patients. No clear correlation was evident between the Schirmer/TBUT scores and the lissamine green/OSDI scores. CONCLUSIONS: The prevalence of dry eye in this population was estimated at approximately 10% to 40% (based on clinical signs) and 40% to 55% (based on symptoms); dry-eye severity was predominantly mild/episodic. The proportion of patients requiring dry-eye therapy (based on OSDI and DEWS severity findings) was almost 2 times higher than the proportion receiving treatment.
