Risk Factors for Dry Eye in Mainland China: A Multi-Center Cross-Sectional Hospital-Based Study

Purpose: To investigate dry eye-associated risk factors in a hospital-based population of China. Methods: It is a multi-center cross-sectional study involving 94 tertiary hospitals all over China. Outpatients in these hospitals were asked to complete McMonnies Questionnaire and undergo dry eye examinations. A total of 31124 participants were finally selected. Results: Of the 31124 participants, 17937 (57.6%) participants were clinically diagnosed as dry eye. The percentage of diagnosed dry eye was higher among women than among men (61.9% versus 53.2%). Dry eye was diagnosed more often with higher age (under 25 years, 47.6%; 25-45 years, 56.6%; over 45 years, 65.6%). In multivariate analysis, independent risk factors for dry eye were female sex (odds ratio [OR] = 1.44; 95% confidence interval [CI], 1.37-1.51), higher age (compared to age<25 years, 25-45 years: OR = 1.42; 95%CI, 1.34-1.51; compared to age<25 years, over 45 years: OR = 2.09; 95%CI, 1.96-2.24), arthritis (OR = 1.51; 95%CI, 1.38-1.65), thyroid diseases (OR = 1.41; 95%CI, 1.27-1.56), refractive surgery (OR = 1.23; 95%CI, 1.15-1.31), antihistamine eye drops (OR = 1.34; 95%CI, 1.23-1.47), diuretics (OR = 1.13; 95%CI, 1.01-1.27), sleeping tablets (OR = 1.21; 95%CI, 1.09-1.34), tranquilizers (OR = 1.60; 95%CI, 1.40-1.82), medication for duodenal ulcer (OR = 1.88; 95%CI, 1.61-2.21) and medication for digestive problems (OR = 1.14; 95%CI, 1.05-1.25). Diabetes was not found to be significantly associated with dry eye in multivariate model (p = .836). Conclusions: Dry eye was commonly diagnosed among ophthalmic outpatients in mainland China. Risk factors for dry eye included female sex, higher age, certain systemic diseases and use of certain medications (see above). Diabetes was not significantly associated with dry eye in this study.