Prevalence of symptomatic dry eye and influencing factors among Chinese adolescents: A cross-sectional study

PLoS One. 2024 Oct 29;19(10):e0312725. doi: 10.1371/journal.pone.0312725. eCollection 2024.

Abstract

Background: Comprehensive research on the impact of various types of refractive errors (RE) and anisometropia on dry eye disease is still lacking. This study aimed to estimate the prevalence rates and potential lifestyle factors related to symptomatic dry eye (SDE) among adolescents in eastern China.

Methods: A cross-sectional study was performed in 2023, and a stratified cluster sampling technique was used among adolescents in Nantong, China. Demographic information, including sex, age and BMI, were collected. All participants underwent optometric tests, while Ocular Surface Disease Index (OSDI) and self-designed questionnaires were administered. Both univariate and multivariate logistic regression analyses were used to assess associations between SDE and related parameters, and various types of RE and anisometropia were also included in the study.

Results: A total of 1,518 participants were enrolled in the study, and the overall prevalence of SDE was 20.3% among adolescents in Nantong, China. Multiple logistic regression analyses showed that high myopia (aOR = 3.42, 95% CI = 1.60-3.36, p = 0.025), frequent use of eye drops (aOR = 2.31, 95% CI = 1.60-3.36, p<0.001), a history of allergic conjunctivitis (aOR = 1.93, 95% CI = 1.09-3.34, p = 0.025), and frequent blinking (aOR = 3.23, 95% CI = 2.31-4.53, p<0.001) were identified as risk factors for SDE. Conversely, male gender (aOR: 0.76, 95% CI: 0.58-0.99, p = 0.043), increased sleep time (6-7 h: aOR = 0.64, 95% CI = 0.46-0.89, p = 0.009; 7-8 h: aOR = 0.64, 95% CI = 0.43-0.95, p = 0.026; >8 h: aOR = 0.43, 95% CI = 0.23-0.82, p = 0.010), and timely intervention when vision decline occurred were protective factors against SDE (aOR = 0.61, 95% CI = 0.43-0.85, p = 0.004).

Conclusion: High myopia was found to be independently associated with an increased risk of SDE., while hyperopia, astigmatism, and anisometropia were not independent risk factors for SDE. The identified risk and protective factors may help provide valuable insights for future research and interventions aimed at improving ocular health in adolescents.

MeSH terms

  • Adolescent
  • Child
  • China / epidemiology
  • Cross-Sectional Studies
  • Dry Eye Syndromes* / epidemiology
  • East Asian People
  • Female
  • Humans
  • Male
  • Prevalence
  • Refractive Errors / epidemiology
  • Risk Factors
  • Surveys and Questionnaires

Grants and funding

This work was supported by funds from Nantong Science and Technology Bureau (No. MSZ2023103), Scientific Research Project of Nantong Health Committee (No. QA2021018, No. MS2023029 and No. QNZ2023033), Research and Development Fund of Kangda College, Nanjing Medical University (No. KD2022KYJJZD017 and No. KD2022KYJJZD018) and Nantong University Clinical Medicine Project (No. 2022LZ004 and No. 2022LZ002). This study received funding support from several projects. Yue Zhou, Yan Zhu, Qi Cai, Zhimin Sun and Xiaobo Huang were the funders of this study. Yue Zhou was responsible for data curation, investigation and writing-original draft. Yan Zhu and Qi Cai were responsible for data validation. Zhimin Sun was responsible for supervision, and Xiaobo Huang was responsible for supervision and writing-review & editing.