BACKGROUND:

To determine the prevalence of dry eye syndrome (DES) in the general 40-64 year-old population of Shahroud, Iran.

DESIGN:

Population based cross-sectional study.

PARTICIPANTS:

Through cluster sampling, 6311 people were selected and 5190 participated. Assessment of dry eye was done in a random subsample of 1008 people.

METHODS:

Subjective assessment for DES was performed using Ocular Surface Disease Index (OSDI) questionnaire. In addition, the following objective tests of DES were employed: Schirmer test, tear break-up time (TBUT), and fluorescein and Rose Bengal staining using the Oxford grading scheme.

MAIN OUTCOME MEASURES:

Those with an OSDI score ≥23 were considered symptomatic, and DES was defined as having symptoms and at least one positive objective sign.

RESULTS:

The prevalence of DES was 8.7% [95% confidence interval (CI): 6.9-10.6]. Assessment of signs showed an abnormal Schirmer score in 17.8% (95% CI: 15.5-20.0), TBUT in 34.2% (95% CI: 29.5-38.8), corneal fluorescein staining (≥1) in 11.3% (95% CI: 8.5-14.1), and Rose Bengal staining (≥3 for cornea and/or conjunctiva) in 4.9% (95% CI: 3.4-6.5). According to the OSDI scores, 18.3% (95% CI: 15.9-20.6) had DES symptoms. The prevalence of DES was significantly higher in women (p=0.010), and not significantly associated with age (p=0.291). The objective DES signs significantly increased with age.

CONCLUSIONS:

Based on the findings, the prevalence of DES in the studied population is in the mid-range. The prevalence is higher in women. Also, objective tests tend to turn abnormal at higher age. Pterygium is associated with DES and increased its symptoms.

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