Severe Dry Eye Tied to Reduced Work Productivity and Activity Levels

By Lisa Rapaport

November 06, 2020

(Reuters Health) - People with more severe dry eye disease have greater impairment in their daily activity and are less productive at work than counterparts with milder dry eye disease, a recent study suggests.

Researchers examined data on 535 people with moderate to severe dry eye disease who had eye health assessments and completed the Ocular Surface Disease Index (OSDI) and Work Productivity and Activity Impairment (WPAI) questionnaires at baseline and at 6 and 12 months; both the OSDI and the WPAI score responses from 0 to 100, with higher scores indicating more severe symptoms or impairments.

At baseline, 279 people (52%) were unemployed and participants reported mean activity impairment scores of 24.5%. Participants' mean OSDI score at baseline was 42.1 (range: 20.8 to 81.3).

Overall, each 10-unit increase in the severity of dry eye symptoms based on OSDI scores was associated with a mean 4.28% increase in work impairment scores and a 4.76% increase in daily activity impairment scores, researchers report in Ophthalmology.

"These findings should encourage all ophthalmic care providers to be persistent in seeking relief from symptoms for their patients," said study coauthor Maureen Maguire, a professor of ophthalmology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.

"Dry eye disease is more than a minor bother, it has a real impact on patients' lives," Maguire said by email.

People who experienced worsening OSDI scores over the study period also had worsening impairment with work and daily activities. Each 10-unit increase in OSDI was associated with a mean 2.00% increase in work impairment and a mean 3.07% increase in activity impairment.

Increasing corneal staining and tear break-up time were also associated with higher levels of work impairment and activity impairment. However, changes in corneal staining and tear break-up time over the course of the study period were not associated with statistically significant differences in work impairment or activity impairment in longitudinal analysis.

One limitation of the study is that the exclusion criteria - such as barring contact lens wearers and requiring people to attend three exams over one year - may limit the generalizability of the results, the study team notes. The lack of a control group of patients without dry eye disorder also makes it impossible to compare baseline work impairment or activity impairment levels among people with and without this eye condition.

"As with most diseases, it is difficult for patients and clinicians to preventatively manage dry eye symptoms, such as by using artificial tears or therapeutic drops before the workplace symptoms occur," said Dr. Kelly Nichols, dean of the University of Alabama at Birmingham School of Optometry.

"Environmental modifications, like reducing air ventilation flow towards the eyes, using appropriate eyeglasses or contacts, and taking screen breaks can help," Dr. Nichols, who wasn't involved in the study, said by email.

Clinicians should talk to patients about any symptoms of dry eye, and any circumstances or patterns that might contribute to the condition, when they come in for annual exams, Dr. Nichols said.

"Dry eye patients, even when well-managed, can have times of the year when their eyes feel worse," Dr. Nichols said. "Catching a patient during that time is helpful in understanding the pattern of dry eye across a year and the severity of clinical findings."

SOURCE: Ophthalmology, online October 14, 2020.