The prevalence of dry eye among adults with inflammatory eyelid, conjunctival and corneal diseases at Muhimbili National Hospital, Dar es Salaam, Tanzania

Abstract

Objectives: This study was designed to determine the prevalence of dry eye among adult patients with eyelid, conjunctival and corneal inflammatory diseases attending outpatient eye clinic at Muhimbili National Hospital. Methods: For a period of one year (February 2000 to January 2001) a total of 200 consecutive new patients, who presented with one or more symptoms of dry eye often or all the time were seen at Muhimbili eye clinic. The patients underwent a comprehensive detailed history and examination. A standardized clinical slit lamp examination was performed on all patients included in the study. Four objective assessments of dry eye were made: tear film break up time, Schirmer test, rose bengal staining and fluorescein corneal staining. Dry eye was diagnosed if a symptomatic patient had abnormality of one or more of the clinical tests. A positive clinical test was defined as: Schirmer s 5mm, tear break up s 10 seconds, rose be ngal score >3 and fluorescein score >3. Results: The population examined varied In age from 20-82 years with a mean age of 37.8 years. Females comprised 69.5% and males 30.5%. Dry eye was diagnosed as follows: 20% by tear break up time, 7% by Schirmer test, 9% by rose bengal stain and 7% by fluorescein stain. Of the study population 2.5% had normal tear stability with low tear secretion, 4.5% had both low tear secretion and stability and

-- -- viii 15.5% had normal tear secretion with low tear stability. Tear secretion and tear stability decreased with increasing age (p<O.OOO 1 and 0.04) respectively. Females comprised the majority of patients with low tear secretion. There was a statistically significant correlation between tear secretion and tear stability (p<O.OOOOI). Among the study group 16(8%) had visual impairment. No patient was blind. The visual impairment was more among patients with low tear secretion and low tear stability. Sand like sensation, soreness, blurred vision and morning eye pain were the symptoms felt most in patients with low tear stability or low tear secretion. Symptoms experienced by patients with normal tear secretion or tear stability were itching, soreness, tearing and sandy like sensation. Conclusion: The present findings suggest that dry eye IS prevalent among patients with eyelid, conjunctival and corneal inflam matory diseases in Dar es salaam. A combination of symptoms and clinical tests is needed for the diagnosis of dry eye syndrome. The prevalence of dry eye varied depending on the test used to diagnose the condition.