Aug. 7, 2003 Boston, MA – Nearly 3.2 million American women age 50 and older suffer from dry eye syndrome, a painful, debilitating eye disease, according to an epidemiological study by scientists from Schepens Eye Research Institute and Brigham and Women's Hospital.
The study, published in the August issue of the American Journal of Ophthalmology and the largest study of its kind, indicates that dry eye in women is an important health issue that may often remain undiagnosed.
The incidence of dry eye syndrome, along with the economic impact on the health care system, is likely to increase as the population ages.
"These findings shine a light on this issue and will help make the public and the health care community more aware of dry eye syndrome as an important health concern for women. It also points to the need for diagnosis and treatment to limit the impact on the individual's quality of life and society," says Debra Schaumberg, ScD, OD, MPH, the senior author of the study, assistant scientist at Schepens Eye Research Institute, associate epidemiologist at Brigham and Women's Hospital (BWH), and an assistant professor at Harvard Medical School.
Known to be more common in women than men (scientists estimate that over a million men age 50 and older have the disease), dry eye syndrome is characterized by a decline in the quality or quantity of tears that normally bathe the eye to keep it moist and functioning well. The condition causes symptoms such as pain, irritation, dryness, and/or a sandy or gritty sensation. If untreated, severe dry eye syndrome can eventually lead to scarring or ulceration of the cornea, and loss of vision. Victims can experience symptoms so constant and severe that reading, driving, working or participating in other activities of daily life are difficult or impossible.
While previous studies have given some indications of the numbers of women (people) affected, these studies were small and geographically and demographically limited.
Schaumberg's study, in contrast, is the first large-scale study that, although not population-based, is geographically diverse, including women from across the United States.
To obtain their results, Schaumberg and her team surveyed over 37,000 women enrolled in the Women's Health Study, the landmark, BWH-based Women's Health Study. Survey questions were designed to elicit information about an individual's history of diagnosed dry eye syndrome or evidence of severe symptoms.
After adjusting for age and demographics, and extrapolating to the U.S. population, the researchers concluded that 7.8 percent of the population of women over age 50 or 3.2 million women, suffered from the disorder. They also concluded that while many younger women in their forties did experience dry eye syndrome, the prevalence of the disease increased significantly with age.
The researchers also found that Hispanic and Asian women were more likely to report severe symptoms, but not more likely to have been diagnosed than Caucasian women. The researchers speculate that this may be due to a lower level of health care in their communities or less effectiveness of treatment, or possibly because of interactions with other medications or health conditions in Hispanics and Asians, such as hypertension. Black women were not distinguishable from white women when it came to dry eye syndrome.
Since the subjects of this AJO study were health workers and likely to be healthier than the general public, Schaumberg and her team believe that the general population may have even a higher incidence of dry eye than the study group.
According to Schaumberg, little attention has been focused on this disease because it can be difficult to study and doesn't usually lead to blindness, but she adds that the cost for care and the debilities it causes could eat up substantial health care resources. "This research points to the high prevalence of dry eye in the population that deserves more study in the future." Schaumberg and her colleagues are not alone in their concern. The National Eye Institute has also identified it as a major concern for future research.
Although all the causes of dry eye are not known, normal aging of tear glands as well as various disorders and diseases seem to be involved. Previous research has shown a link between levels of the male sex hormone androgen and the disease. In addition, Schaumberg recently published research that linked dry eye syndrome to postmenopausal hormone therapy in women. While artificial tears in the form of eye drops offer some relief and other treatments are also available or in clinical trials, the disease is not curable.
### Collaborators on the study include David A. Sullivan, PhD, Schepens Eye Research Institute; M. Reza Dana, MD, MPH, Schepens Eye Research Institute and Massachusetts Eye and Ear Infirmary; and Julie E. Buring, ScD, Division of Preventive Medicine, Brigham and Women's Hospital.
Schepens Eye Research Institute, an affiliate of Harvard Medical School, is the largest independent eye research institute in the world.
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