Prevalence of Dry Eye and its Subtypes in an Elderly Population with Cataracts in Indonesia
Received 25 May 2020
Accepted for publication 1 July 2020
Published 24 July 2020 Volume 2020:14 Pages 2143—2150
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Nina Asrini Noor,1 Tri Rahayu,1,2 Tjahjono D Gondhowiardjo1,2
1JEC Eye Hospitals and Clinics, Jakarta, Indonesia; 2Ophthalmology Department, Cipto Mangunkusumo Kirana Hospital, Jakarta, Indonesia
Correspondence: Nina Asrini Noor
JEC Eye Hospital Kedoya, Jalan Terusan Arjuna Utara Nomor 1, Jakarta Barat, DKI, Jakarta 11520, Indonesia
Tel +62 813 9520 9670
Purpose: To describe the prevalence of dry eye disease (DED) and its subtypes in elderly population with cataracts prior to surgery in Jakarta, Indonesia.
Patients and Methods: Forty-nine eyes of 49 patients (16 males, 33 females; mean age: 66.6 years) planned for phacoemulsification surgery were consecutively recruited from two tertiary eye hospitals in this hospital-based cross-sectional study. Symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire, and the patient was defined as symptomatic if their OSDI score was ≥ 13. Objective examinations included the noninvasive tear film break up time (NIBUT) and Schirmer tests. The results were deemed abnormal if they were < 10 seconds and < 10 mm for NIBUT and Schirmer, respectively.
Results: Participants were classified into four groups: DED (positive symptoms and short NIBUT), preclinical dry eye (positive symptoms without short NIBUT), predisposition to dry eye (short NIBUT without symptoms), and normal group. Median OSDI score was 12.5 (0– 45.0), NIBUT was 10.4 (5.1– 28.9) seconds, and Schirmer score was 8.0 (2.0– 28.0) mm. The prevalence of DED, preclinical dry eye, and predisposition to dry eye were 22.5%, 22.5%, and 26.5%, respectively, while the other 28.5% subjects were normal. The DED group had significantly lower Schirmer test results (4.0 [2– 17] mm) compared to all other groups. Older age (> 70 years) was associated with poorer NIBUT and Schirmer test results and a significant difference between age groups was observed, especially in males.
Conclusion: Dry eye is a common problem among the elderly population with cataracts in Indonesia. Almost half of the subjects presented with dry eye symptoms and either categorized as DED or preclinical dry eye, while more than one quarter were predisposed to dry eye. Care must be taken prior to cataract surgery to rule out existing dry eye with additional attention on those presenting without any symptoms as dry eye may develop after surgery.
Keywords: dry eye, elderly population, tear film, cataract, cross-sectional study
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