Evaluation of dry eye disease in geriatric and pre-geriatric middle aged subjects attending a tertiary care hospital in Puducherry

Session Details

Session Title: Quality of Vision and Dry Eye

Session Date/Time: Sunday 08/10/2017 | 08:00-09:30

Paper Time: 08:18

Venue: Room 3.4

First Author: : L.Krishnamurthy INDIA

Co Author(s): :    S. Thanikachalam   G. Behera   J. Ramesh              

Abstract Details

Purpose:

This study aims to determine the prevalence and risk factors of dry eye disease in the Geriatric (>65 years) and Pre-geriatric (40-65 years) populations in a hospital based setting and to compare the same between both the groups.

Setting:

Geriatric and General Medicine out-patient departments in a tertiary care hospital in South India

Methods:

All patients above 40 years attending the Medicine and Geriatric out-patient departments were given the Mc Monnie and Ho screening questionnaire for dry eye symptoms and risk factors and those with a score of > 14.5 were further evaluated in the Ophthalmology department using Ocular Surface Disease Index (OSDI) severity subjective questionnaire, and objective clinical tests inclusive of Schirmer’s test, assessment of Meibomian Gland Dysfunction (MGD), Tear Film Break Up Time (TBUT), Fluorescein staining and Impression cytology for assessment of dry eye. The prevalence, risk factors, clinical signs and symptom-sign correlation were determined and compared between the two groups.

Results:

Among the 1029 patients screened, the prevalence of dry eye was 9.9%, being significantly higher among the geriatric (15.4%) versus pre-geriatric group (7.7%), among women (12%) versus men (6.6%), among arthritic (22.8%) versus non-arthritic (9.6%), and among diabetic (30.4%) versus non-diabetic patients (3.4%). Geriatric arthritic patients had significantly lower Schirmer’s scores while diabetic patients had lower Schirmer’s and TBUT scores. Majority of patients showed moderate to severe OSDI scores. Geriatric patients had a greater prevalence of Grade 4 MGD (66%) versus pre- geriatric group (26.9%). TBUT scores were low in both groups and co-related with OSDI scores (r=1).

Conclusions:

The prevalence of dry eye was more in the geriatric than pre-geriatric group and among females than males. Arthritis and diabetes were found to be significant risk factors, with arthritic patients having aqueous component deficiency and diabetic patients having an aqueous and evaporative dry eye. All the symptomatic patients in both groups had Meibomian gland disease. TBUT correlated well with OSDI scores. We conclude that the Mc-Monnie and Ho questionnaire is a valid screening tool for evaporative dry eye and is complemented by OSDI for screening in a hospital based setting.

Financial Disclosure:

NONE