The Dry Eye Zone

Rebecca's Blog


Dry eye epidemiology in the golden age of Restasi$

So many angles on the epidemiology of dry eye….

There are a lot of ways to try to figure out how many people get dry eye. One of the more popular ways, at least in the US, is to study medical claims databases.

This recent study looked at a Department of Defense military health system claims database serving nearly 10 million people.

That’s… a lot of data. This had better be good.

So, what do they look for in a claims database to find dry eye?

It’s a state secret.

Seriously, it’s some kind of sophisticated algorithm based on:

  • “Selected diagnostic and procedure codes.”

  • Prescriptions of cyclosporine ophthalmic emulsion.

  • Diagnostic codes for the indicators of “other common ocular conditions”.

Actually, it’s all about Restasis.

A/k/a bullet point #2 above.

Look at the dates of this study: 2003 - 2015. That is an exact match for the years when Restasis was the only dry eye prescription drug on the US market. That makes life a lot easier. You pull in all the Restasis claims, then you add in enough other stuff to make up for the fact that not all doctors always prescribe Restasis to all dry eye patients.

Okay, so I’m dumbing it down. A little. Can you blame me?


In 2003 to 2015 (a/k/a “The Restasis Years”), dry eye disease was….

  • the 5th most prevalent ocular condition in women

  • the 9th most prevalent ocular condition in men

2012 was apparently a ‘banner year’ when dry eye disease ranked way up at #3, behind only refraction/accommodation (e.g. “I need glasses”) and cataracts. Heh. I’m tempted to go back and dig through some Allergan annual reports to see if sales spiked that year and what they attributed it to.

I don’t know. Nothing here to set the pulses racing, if you ask me. On the other hand, I really enjoyed a previous study by these authors when they milled that same DOD data for dry eye comorbidities. That’s what I’d like to see more of.

The abstract

Dry eye disease ranking among common reasons for seeking eye care in a large US claims database. Bradley et al, Clinical Ophthalmology, February 2019


This study provided further epidemiologic evidence for DED as a commonly occurring condition that drives patients to seek treatment.

Uh huh.