Age Associations with Dry Eye Clinical Signs and Symptoms in the Dry Eye Assessment and Management (DREAM) Study

Gender-Related Differences in Dry Eye Symptoms Following Involutional Ectropion and Entropion Surgery

This prospective case-control study investigated gender-related differences in dry eye symptoms following surgery for involutional ectropion and entropion. A total of 109 patients, aged between 65 and 89, were categorized by eyelid condition and gender. Postoperative assessments included the Tear Film Break-Up Time (TBUT) test, Schirmer I test results, corneal and conjunctival staining, eyelid margin characteristics, and scores from the Ocular Surface Disease Index (OSDI) questionnaire. The analysis revealed notable gender-related differences in dry eye manifestations. Initially, men exhibited lower TBUT scores but higher Schirmer test readings compared to women; however, these disparities diminished over time. No significant gender differences were detected in corneal and conjunctival staining, indicating similar levels of ocular surface damage across genders. Males showed significantly higher values in several eyelid margin characteristics (LMI, LMT) at various postoperative time points. According to the OSDI questionnaire, women experienced more severe symptoms of dry eye both pre- and post-operatively, suggesting a greater subjective symptom burden. When comparing surgical outcomes for ectropion and entropion, both conditions showed improvement in eyelid positioning and dry eye symptoms post-surgery. Despite these improvements, women with either condition reported more severe dry eye symptoms compared to men throughout the postoperative period. This study highlights the gender-specific variations in dry eye symptoms following eyelid malformation surgery and emphasizes the importance of adopting gender-sensitive approaches in postoperative care to improve outcomes and ocular health.

Subjective Dry Eye Symptoms and Objective Ocular Surface Signs in a Civil Air Crew Population: A Cross-Sectional Study

Background Aviation professionals are often exposed to conditions such as low cabin air pressure, reduced humidity, and prolonged artificial lighting, which may predispose them to dry eye disease (DED). We therefore designed a cross-sectional study with three primary objectives. Our first aim was to determine the prevalence of subjective dry eye symptoms among civil flight personnel. To achieve this, we administered the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire. Second, we performed ocular examinations to assess objective DED indicators, such as the Schirmer's-1 (SCH-1) test and tear film break-up time (TBUT). We then correlated the results of these objective tests with the subjective symptoms reported by the participants. Last, we aimed to identify the independent risk factors for positive SCH-1 and TBUT results among aircrew personnel who did not report subjective dry eye symptoms. Methods The study sample consisted of 189 aircrew personnel (94 men and 95 women; mean age: 35.8 ± 10.4 years). They completed the SPEED questionnaire, a tool for assessing ocular surface symptoms. Participants' symptoms were classified as normal (SPEED scores 0-6), moderate (SPEED scores 7-15), or severe (SPEED scores 16-28). The objective assessment included the SCH-1 test for tear production and the TBUT test for tear film quality. Results A significant majority of participants (n = 165; 87.3%) did not report any subjective symptoms of DED. However, 12.2% (n = 23) and 0.5% (n = 1) of the study subjects experienced moderate and severe symptoms, respectively. The SCH-1 test and TBUT test were positive in 25.4% (n = 48) and 24.9% (n = 47) of the participants, respectively. Interestingly, among the aircrew personnel who did not report any subjective dry eye symptoms (SPEED scores 0-6), 18.8% (n = 31) and 17.6% (n = 29) showed abnormal results on the SCH-1 test and TBUT, respectively. Age was identified as the only independent predictor of a positive TBUT (odds ratio = 1.05, 95% confidence interval (CI) = 1.01-1.08, p = 0.01), with a borderline significant association with a positive SCH-1 test (odds ratio = 1.03, 95% CI = 0.99-1.07, p = 0.06). Conclusions The disparity between subjective symptoms and objective tests emphasizes the significance of incorporating objective measures for screening and diagnosing DED in civil flight personnel. If independently confirmed by future research, our findings could potentially lead to the routine implementation of surveillance protocols that incorporate objective DED indicators. Moreover, as age emerged as an independent predictor of positive results on objective tests, it is crucial to consider age-specific screening strategies.