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  • Lifestyle

Studies Report Impact of Dry Eye Disease on Quality of Life

  • Last updated November 8, 2022

8 min read

Heather Cottrell
Written byHeather Cottrell
Jovi Boparai, MD
Reviewed by Jovi Boparai, MD
Heather Cottrell
Heather Cottrell

Bio

Since becoming a Certified Health Coach in 2005, researching and creating content to help people live longer, healthier lives is my passion. As a content creator and online marketing coach for health coaches, I spend most of my time working on screens. Keeping my eyes healthy is important not just to my work, but to my life!

Get to know me a little better!

Hobby: creating content
Food: is coffee a food? ;)
Superhero: Wonder Woman
Guilty pleasure: bingewatching my favorite shows
Secret power: learning online tech quickly

Training:

Undergraduate: Fordham University
Health and wellness training: Institute for Integrative Nutrition

Jovi Boparai, MD
Jovi Boparai, MDCo-founder & CEO of CorneaCarePhiladelphia, PA

Bio

Dry eye disease is tough! I get it. I have struggled with dry eyes for several years from contact lens use, and from spending countless hours looking at computer screens. In college, my dry eyes got so bad that I couldn’t wear contact lenses, because of a constant “foreign body sensation” when I had them in. I had to stop reading every 30 minutes because my eyes would start to burn and my vision would get blurry. I tried a plethora of treatments and nothing seemed to work. Dry eye disease was not only impacting my eyes, but also my emotional wellbeing. It was preventing me from enjoying life, and getting in the way of my professional training. I felt overwhelmed, frustrated and hopeless.

It was only when I realized that my dry eyes were linked to my lifestyle, environment and overall health did things start to make sense. I noticed that on days when I spent less time on the computer, my eyes felt better. My symptoms would flare when it was windy, or when there was low humidity. I knew that if I wanted to get ahead of my dry eyes, I needed to not only treat my eyes, but to also address my lifestyle. I started a consistent regimen of artificial tears and eyelid hygiene. I switched from monthly contact lenses to daily contact lenses. I started taking scheduled breaks from looking at a computer. I ate a healthier diet focused on anti-inflammatory/antioxidants foods, and I bought a humidifier for my room. In the beginning doing all this seemed impossible, but over time it became part of my usual routine. Not only did my eyes feel better, but I was overall healthier and happier! Turns out what is good for my eyes, was also good for my mind and body. I carried this lesson with me as I started my career to become an ophthalmologist and ophthalmic surgeon.

Because of my personal journey and professional training, I believe dry eye treatment starts by listening to and empowering the patient. I listen for the struggles and cue in on their strengths, while picking up on their lifestyle. Only then do we together start building a treatment plan that incorporates good eye hygiene with small, but impactful lifestyle changes. Our sight is our most important sense, and it is intimately linked to our very being. I want dry eye patients to not only get their dry eyes under control, but to also enjoy good mental and physical health, and live a fulfilling life. What is good for the eyes should also strengthen the mind and fortify the body!

Get to know me a little better!

Hobby: vintage watches
Food: peanut butter
Superhero: Superman
Guilty pleasure: desserts
Secret power: has never had a headache

Training:

Undergraduate: University of Pittsburgh Honors College
Medical school: Weill Cornell Medicine
Ophthalmology residency: Wills Eye Hospital.

Impact of Dry Eye Disease on Quality of Life

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Table of Contents

Dry eye disease patients report a lower health-related quality of life, studies find. In this article, we learn how researchers study the impact of dry eye disease on quality of life, and what conclusions they’ve made.

Experts report that dry eye disease (DED) is a growing public health concern. The condition causes ocular symptoms such as discomfort, fatigue, and visual impairment that impact the sufferer’s quality of life (QoL) in a number of ways. DED is found to negatively impact aspects of a patient’s physical, social, and mental functions, as well as daily activities and performance at work.1

Key Points

  • Studies show the impact of dry eye disease on quality of life.
  • Reduced vision and falls are key factors for patients reporting poor quality of life with dry eye disease.
  • Lifestyle changes and eye care treatments can improve symptoms and quality of life.
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Taking the First Step

Dry eye disease (DED) is one of the most prevalent eye conditions in the world. Reports state that the prevalence of dry eye disease ranges from around 5% to as high as 50% in adults 50 and older across the globe. In the US alone, modest estimates report that 30 million adults suffer from dry eye symptoms, of which 5 million likely have moderate to severe dry eye disease.1

It can be difficult to quantify the entire impact of dry eye disease on a person’s quality of life (QoL). Researchers continue to develop new evaluation modalities to help measure the impact. With techniques for measuring impaired vision and patient questionnaires, researchers are beginning to better understand the full impact dry eye disease can have on different areas of a patient’s quality of life.1

What is Dry Eye Disease?

To best understand the findings of the studies discussed in this article, let’s start with a review of dry eye disease.

Dry eye disease is a common condition, and often the reason older adults seek out a healthcare provider. Women and adults over 50 are most commonly affected, though dry eye disease can be found in people of any age.

Symptoms of dry eye disease include ocular pain, burning, redness, blurred vision, foreign body sensation, and crusty eyelids.2

Key symptoms of dry eye disease

Also known as keratoconjunctivitis sicca, ocular surface disease, and dry eye syndrome, dry eye disease is caused by an unstable tear-film and inflammation.3

Types of Dry Eye Disease

There are several causes of dry eyes that fall under two main categories: decreased tear production and rapid tear evaporation. 

With decreased tear production (aqueous deficient DED), your eyes don’t produce adequate tears to keep the eye surface, including the cornea, lubricated. This type of dry eye disease is often related to the following risk factors:

  • autoimmune conditions such as Sjögren’s syndrome, rheumatoid arthritis, and sarcoidosis
  • medical conditions such as diabetes, high blood pressure, cancer, thyroid problems, and menopause
  • side effects from oral medications including antihistamines, decongestants, antidepressants, beta-blockers, diuretics, and oral contraceptives
Causes of dry eye disease

With evaporative DED, you have enough tears but they evaporate too quickly due to an unstable tear film. Evaporative dry eye disease is often caused by:

  • contact lens use
  • LASIK eye surgery
  • (MGD) meibomian gland dysfunction (clogged oil glands in your eyelids)
  • blepharitis (eyelid inflammation)
  • rosacea
  • eye infections (corneal ulcers)
  • eye conditions (corneal transplant and glaucoma)
  • damaged to the ocular surface from prolonged use of eye drops with preservatives

Impact of Dry Eye Disease on Quality of Life

Thanks to the work of researchers, there is a growing number of improved techniques that help measure the impact of dry eye disease on quality of life (QoL) in dry eye patients. Most significant is a better understanding of how dry eye disease interferes with vision.

While standard testing techniques fail to show these abnormalities, new dry eye questionnaires and more sensitive testing are able to measure what’s really going on. Results of these tests are contributing to a growing body of evidence showing visual disturbances such as blurred or foggy vision, fluctuating vision, and glare are commonly reported among dry eye disease patients.1

Social impacts of dry eye disease

In addition to self-reported visual impairment, researchers can now understand how dry eye disease impacts a person’s daily living and quality of life in so many other areas. Patients report impacts to their social life, mental health, productivity on the job, as well as physical discomforts. Clearly, the studies on vision-related quality of life indicate that dry eye disease impacts far more than the eyes.1

Dry eye patients report physical pain and discomfort, similar to sufferers of chronic pain syndrome. This chronic eye condition causes both physical pains as well as negative effects on everyday quality of life.1

How Impact of Dry Eye Disease on Quality of Life is Measured

According to ophthalmologist Laura M. Periman, MD, there are a number of questionnaires that can be used to measure the impact of dry eye disease on quality of life. These include the SPEED (Standard Patient Evaluation of Eye Dryness Questionnaire), OSDI (Ocular Surface Disease Index), and the IDEEL (Impact of Dry Eye in Everyday Life).4

Such questionnaires are a valuable tool to measure progress during treatment of dry eye disease by quantifying its impact on a patient’s work productivity, social relationships, mobility, and other daily activities.

The workplace and dry eye disease

The Singapore Study

The British Journal of Ophthalmology published a 2021 report showing the relationship between dry eye disease and poor general health-related quality of life. It appears the association is due to reduced visual quality and the occurrence of recent falls.5

Researchers performed a cross-sectional study to determine how dry eye symptoms affect quality of life. In the study, researchers considered the symptoms experienced by dry eye patients and how they scored on the visual function questionnaire. The statistical model used considered demographic and socioeconomic factors, as well as comorbidities. Ocular and system examination results were also taken into account.

Environmental conditions that affect dry eye disease

With a total of over 7,700 participants, the team found that people with dry eye symptoms reported a much lower quality of life than those who do not suffer from dry eye disease.5

The researchers concluded that “efforts to reduce severity of dry eye symptoms are essential to optimize patients’ overall functioning and well-being.”5

The UK Study on Dry Eye Disease and Quality of Life

The 2014 study at the University of Southampton in the UK, looked at the effect of dry eye disease on adults in the UK. The study included 1000 dry eye patients and 1000 adults without the condition.

Researchers used online surveys and visual function questionnaires from the National Eye Institute, alongside a QoL questionnaire on health-related quality of life.6

The results of the 2014 study indicated that patients with dry eye disease reported a lower quality of life as compared to adults without dry eye symptoms. Dry eye patients experienced visual impairment and related mobility issues. According to the findings, the participants with dry eye disease also reported more anxiety and depression.6

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Participants with severe dry eye symptoms reported a greater negative impact on their work productivity, mental health, and daily social life.6

While both participant groups reported equal amounts of screen use, the group with symptoms of dry eye disease also reported exposure to environmental triggers including air pollution, forced heat, and air conditioning, known to contribute to dry eye symptoms.6 

The Southampton study demonstrates that dry eye patients suffer lower quality of life with impacts on their vision, daily activities, and work productivity.7

Study Compares Dry Eye Disease and Heart Disease Impacts on Quality of Life

A 2003 study led by Rhett Schiffman, MD, MS, MHSA, measured the quality of life of heart disease patients and compared it with the impact of severe dry eye disease on quality of life. The research found the impact very similar.8 

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What’s Next

Learn to love your eyes! Read more eye health and wellness tips on our blog.

Bibliography

  1. Uchino M, Schaumberg DA. Dry Eye Disease: Impact on Quality of Life and Vision. Curr Ophthalmol Rep. 2013 Jun;1(2):51-57. doi: 10.1007/s40135-013-0009-1. PMID: 23710423; PMCID: PMC3660735. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660735/ Accessed 17 September 2022.
  2. Mayo Clinic. “Dry Eyes.” Mayo Clinic, 2020, https://www.mayoclinic.org/diseases-conditions/dry-eyes/symptoms-causes/syc-20371863. Accessed 30 August 2021.
  3. Tear Film & Ocular Surface Society. Dry Eye Workshop II Report. Ocular Surface Journal, 2017. TFOS DEWS II Report, http://www.tfosdewsreport.org/.
  4. “Impact of Dry Eye Disease on Quality of Life”, Managed Healthcare Executive. https://www.managedhealthcareexecutive.com/view/impact-of-dry-eye-disease-on-quality-of-life. Accessed 22 September 2022.
  5. Lim EWL, Chong CCY, Nusinovici S, et al. Relationship between dry eye symptoms and quality of life: associations and mediation analysis. Bri J Ophthalmol. doi:10.1136/bjo-2022-321246. https://bjo.bmj.com/content/early/2022/08/08/bjo-2022-321246. Accessed 17 September 2022.
  6. “Dry eye disease negatively affects physical and mental health as well as vision”. Science Daily, https://www.sciencedaily.com/releases/2021/03/210311113547.htm. Accessed 25 September 2022.
  7. Hossain, P., et al. (2021) Patient-reported burden of dry eye disease in the UK: a cross-sectional web-based survey. BMJ Open. doi.org/10.1136/bmjopen-2020-039209. Accessed 17 September 2022.
  8. Schiffman RM, Walt JG, Jacobsen G, Doyle JJ, Lebovics G, Sumner W. “Utility assessment among patients with dry eye disease”. Ophthalmology. 2003 Jul;110(7):1412-9. doi: 10.1016/S0161-6420(03)00462-7. PMID: 12867401. https://pubmed.ncbi.nlm.nih.gov/12867401/. Accessed 25 September 2022.
  9. Kawashima, Motoko, et al. “Impact of lifestyle intervention on dry eye disease in office workers: a randomized controlled trial.” Journal of Occupational Health, vol. 60, no. 4, 2018, pp. 281–288. Wiley Online Library, https://onlinelibrary.wiley.com/doi/abs/10.1539/joh.2017-0191-OA.

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