The Dry Eye Zone

Rebecca's Blog


Study: Undiagnosed dry eye - survey results

This was a very interesting survey-based study out of Keio University’s dry eye center, and incidentally, the dry eye world’s uncontested Numero Uno (Dr Tsubota) is a co-author. Really well conducted surveys can add a lot to our understanding of dry eye and one of things I love about the Keio U folks - possibly what I really mean is Japanese dry eye researchers as a whole, though - is the balance of the intensely practical (who else actually studies the effects of moisture chamber glasses?) with the intensely scientific.

So in this study, they surveyed a population and separated out two groups:

  • People who have been diagnosed with dry eye, vs

  • People who have not been diagnosed with dry eye BUT based on use of a symptom survey (something you hear me beating the drums for a lot, and that’s going to increase as we get closer to Dry Eye Awareness Month), can reasonably be assumed to have dry eye.

Of those who had not been diagnosed, typically they had one or more of the following risk factors:

  • younger (risk went up for every year the age went down)

  • female (yeah yeah we know)

  • prolonged screen time (boy do we know)

The age factor interested me more in a Japanese study than it would have if it were in the US, where younger age so often means you don’t have a job with healthcare benefits so you’re not going to the doctor any more than you absolutely have to.

Anyway, the final points of interest in the abstract:

  • Men do less to take care of their undiagnosed dry eyes than women do

  • The undiagnosed people who did the least to compensate were taking a quality-of-life hit comparable to the diagnosed people.

Did I mention I love surveys? If you want to learn about people with dry eye, ASK them questions and quantify the results. What I’m really interested in though is getting patients involved in the process of figuring out which questions ought to be asked in the first place. Hobby horse.

Characteristics of Individuals with Dry Eye Symptoms Without Clinical Diagnosis: Analysis of a Web-Based Survey. Yamanishi et al, J Clin Med. 2019 May 21;8(5)


Currently, the available treatment for dry eye disease (DED) varies. The present study aimed to investigate the characteristics of undiagnosed DED and patient-based self-care management for DED based on a web-based survey performed for Tear's Day in Japan; 1030 participants (301 women) responded; 155 participants (72 women) had a clinical diagnosis of DED. We defined undiagnosed DED (n = 116; 54 women) as those with DED symptoms, as evaluated by a frequently used questionnaire despite not having a clinical diagnosis. A multivariate adjusted model indicated that younger age (odds ratio (OR), 0.97 for each one-year decrease; 95% confidence interval (CI), 0.95-0.99), female sex (OR, 2.12; 95% CI, 1.28-3.50), and prolonged visual display terminal usage (OR, 1.12; 95% CI, 1.04-1.21) were risk factors for undiagnosed DED. To investigate the efficacy of self-care management for DED, a sub-analysis was conducted. The number of self-care methods used was significantly higher among women than men. For undiagnosed DED, those with less than three self-care methods had a significantly worse Dry Eye-related Quality-of-Life Score compared with those with diagnosed DED. This study revealed risk factors for undiagnosed DED; individuals with those risk factors need to be clinically assessed and should not rely solely on self-care.