Prevalence of dry eye syndrome in an adult population

Hassan Hashemi, Mehdi Khabazkhoob, Ahmad Kheirkhah, Mohammad Hassan Emamian, Shiva Mehravaran, Mohammad Shariati, Akbar Fotouhi

Research output: Contribution to journalArticlepeer-review

80 Scopus citations


Background: To determine the prevalence of dry eye syndrome in the general 40- to 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 dry eye syndrome was performed using Ocular Surface Disease Index questionnaire. In addition, the following objective tests of dry eye syndrome were employed: Schirmer test, tear break-up time, and fluorescein and Rose Bengal staining using the Oxford grading scheme. Main Outcome Measures: Those with an Ocular Surface Disease Index score ≥23 were considered symptomatic, and dry eye syndrome was defined as having symptoms and at least one positive objective sign. Results: The prevalence of dry eye syndrome was 8.7% (95% confidence interval 6.9-10.6). Assessment of signs showed an abnormal Schirmer score in 17.8% (95% confidence interval 15.5-20.0), tear break-up time in 34.2% (95% confidence interval 29.5-38.8), corneal fluorescein staining (≥1) in 11.3% (95% confidence interval 8.5-14.1) and Rose Bengal staining (≥3 for cornea and/or conjunctiva) in 4.9% (95% confidence interval 3.4-6.5). According to the Ocular Surface Disease Index scores, 18.3% (95% confidence interval 15.9-20.6) had dry eye syndrome symptoms. The prevalence of dry eye syndrome was significantly higher in women (P=0.010) and not significantly associated with age (P=0.291). The objective dry eye syndrome signs significantly increased with age. Conclusions: Based on the findings, the prevalence of dry eye syndrome 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 dry eye syndrome and increased its symptoms.

Original languageEnglish (US)
Pages (from-to)242-248
Number of pages7
JournalClinical and Experimental Ophthalmology
Issue number3
StatePublished - Apr 2014
Externally publishedYes


  • Dry eye
  • Iran
  • Population-based study
  • Prevalence

ASJC Scopus subject areas

  • Ophthalmology


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