Prevalence of Dry Eye Syndrome and Association with Life Behaviors in Adolescents

Jong Joo Lee; Jae Yun Sung; Sung Bok Lee

doi:10.3341/jkos.2017.58.4.387

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Lee, Sung, and Lee: Prevalence of Dry Eye Syndrome and Association with Life Behaviors in Adolescents

Original Article

J Korean Ophthalmol Soc 2017;58(4):387-394.

Published online: 8 September 2017

DOI: https://doi.org/10.3341/jkos.2017.58.4.387

Prevalence of Dry Eye Syndrome and Association with Life Behaviors in Adolescents

Jong Joo Lee, MD, PhD, Jae Yun Sung, M.D., Sung Bok Lee, MD, PhD

Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea

Address reprint requests to Sung Bok Lee, MD, PhD Department of Ophthalmology, Chungnam National University Hospital #282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea Tel: 82-42-280-7604, Fax: 82-42-255-3745 E-mail: sblee@cnu.ac

Received 17 November 20165 February 2017 Accepted 21 March 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the prevalence and risk factors of dry eye syndrome (DES) among adolescents based on the Ocular Surface Disease Index (OSDI) questionnaire.

Methods

A questionnaire survey was conducted on middle and high school students in Daejeon. DES was diagnosed by an OSDI score ≥ 13. According to the OSDI score, DES was classified as mild (13-22 points), moderate (23-32 points), or severe (33-100 points). Additionally, responses to the questions regarding adolescents’ life behaviors including the duration of elec-tronic device use per week (cellphone, computer, TV), study hours per day, sleeping hours per day, contact lenses use, glasses use, and humidifier use were analyzed to determine the associations with DES.

Results

Of 332 students, DES was diagnosed in 147 (44.3%), and 54 (16.3%) complained of severe DES. The prevalence of DES was higher in female students (p = 0.004), long-time electronic device users (divided on the basis of the mean value, 15.3 hours per week, p = 0.011), and contact lenses users (p = 0.001). The prevalence of DES was 53.9% in groups with ≥ 14 hours of electronic device usage time per week, 40.2% in groups with ≥ 7 hours, and 33.7% in groups with < 7 hours (p = 0.002). The duration of electronic device use per week was a significant risk factor of DES for male students, and contact lenses use was a significant risk factor of DES for female students (p = 0.009).

Conclusions

The prevalence of DES was high among adolescents. Long-time electronic device usage and contact lenses wear were associated with DES and increased the risk of DES.

Keywords: Adolescent, Dry eye, Electronic device, Ocular surface disease index, Prevalence

References

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Table 1.

Prevalence of dry eye syndrome according to respondents’ basic characteristics and severity

Characteristics		No.	DES (n, %)	Mild DES (OSDI 13-22)	Moderate DES (OSDI 23-32)	Severe DES (OSDI 33-100)
Gender	Male	208	79 (38.0)^*	39 (18.8)^†	12 (5.8)^†	28 (13.5)^†
	Female	124	68 (54.8)^*	21 (16.9)^†	21 (16.9)^†	26 (21.0)^†
School Level	Middle school	162	63 (38.9)	33 (20.4)	13 (8.0)	17 (10.5)
	High school	170	84 (49.4)	27 (15.9)	20 (11.8)	37 (21.8)
Total		332	147 (44.3)	60 (18.1)	33 (9.9)	54 (16.3)

^* The prevalence was higher in women than in men (chi-square test, p = 0.004).

^† There were differences in the percentages of moderate and severe DES between male and female students (chi-square test, p = 0.001).

DES = dry eye syndrome; OSDI = ocular surface disease index.

Table 2.

Association between life behavior variables and dry eye syndrome

Variables		No.	DES		p-value^*	Odds ratio (95% CI)
Variables		No.	No.	%	p-value^*	Odds ratio (95% CI)
Electronic device use per week	≥15.3 hours	110	60	54.5	0.011	1.862
	<15.3 hours	222	87	39.2		(1.173-2.956)
Study hours per day	≥10.2 hours	146	69	47.3	0.391	1.241
	<10.2 hours	186	78	41.9		(0.802-1.919)
Sleeping hours per day	≥6.7 hours	159	66	41.5	0.388	0.806
	<6.7 hours	173	81	46.8		(0.522-1.245)
Contact lenses wear	Yes	35	25	71.4	0.001	3.586
	No	297	122	41.1		(1.662-7.737)
Glasses wear	Yes	221	105	47.5	0.119	1.487
	No	111	42	37.8		(0.933-2.369)
Humidifier use	Yes	27	14	51.9	0.532	1.393
	No	305	133	43.6		(0.633-3.063)

DES = dry eye syndrome; CI = confidence interval.

^* Chi-square test.

Table 3.

Life behavior variables affecting dry eye syndrome among adolescents

Variables	Group	DES (n, %)	Mild DES (OSDI 13-22)	Moderate DES (OSDI 23-32)	Severe DES (OSDI 33-100)
Electronic device use per week	≥14 hours (n = 141)	76 (53.9)^*	26 (18.4)	20 (14.2)^†	30 (21.3)^†
	<14 hours (n = 102)	41 (40.2)^*	21 (20.6)	8 (7.8)^†	12 (11.8)^†
	<7 hours (n = 89)	30 (33.7)^*	13 (14.6)	5 (5.6)^†	12 (13.5)^†
Contact lenses wear	Yes (n = 35)	25 (71.4)^‡	6 (17.1)	7 (20.0)^§	12 (34.3)^§
	No (n = 297)	122 (41.1)^‡	54 (18.2)	26 (8.8)^§	42 (14.1)^§

^* The prevalence increased as adolescents used electronic devices for longer periods of time (chi-square test, linear-by-linear association, p = 0.002).

^† The prevalence of moderate to severe DES also increased in groups with longer use of electronic devices (chi-square test, linear-by-line-ar association, p = 0.002).

^‡ The prevalence was higher among contact lenses users (chi-square test, p = 0.001).

^§ The prevalence of moderate to severe DES was also higher among contact lenses users (chi-square test, = 0.001).

DES = dry eye syndrome; OSDI = ocular surface disease index.

Table 4.

Logistic regression evaluating factors predictive of dry eye syndrome among adolescents

Stratification	Fa	ctors	Odds ratio (95% CI)	p-value
Male (n = 208)	Electronic devices			0.027
		≥14 hours/<7 hours	2.200 (1.099-4.404)	0.026
		<14 hours/<7 hours	0.983 (0.470-2.055)	0.964
Female (n = 124)	Contact lenses	Yes/No	3.723 (1.382-10.029)	0.009
Non-CL users (n = 297)	Electronic devices			0.017
		≥14 hours/<7 hours	2.183 (1.221-3.903)	0.008
		<14 hours/<7 hours	1.217 (0.653-2.268)	0.537

CI = confidence interval; CL = contact lenses.

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