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AAOPT: Study Finds Dry Eye Cases on Rise

— Military database shows rapid increase from 2005-2012

MedpageToday

ANAHEIM, Calif. -- Among the many millions of people covered by military healthcare, rates of dry eye disease have jumped over the past dozen years, an industry-funded study suggested.

Overall, an estimated 5% of beneficiaries showed signs of the condition in the analysis covering the period 2003-2015, reported Lt. Cmdr. John Bradley, OD, of the in Dayton, Ohio.

"It's definitely a significant issue," said Bradley, speaking at the here, although it's not clear why dry eye disease is being diagnosed so much more than in the past.

"It may have something to do with the capturing of the data via electronic records," he said. "There may be more awareness. Or it just could be the technology: You're blinking less when you read a computer screen or use a handheld device."

According to Bradley, previous studies have reported a wide range of prevalence levels of dry eye disease, with few exploring the rates in those under 50.

For the new study, researchers examined a "cradle to grave" database of medical records of 9.7 million beneficiaries covered by the U.S. Department of Defense from 2003 to 2015. They used ICD-9 codes and prescriptions for cyclosporine ophthalmic emulsion to track apparent cases of dry eye disease.

Annual incidence rates for the condition -- in those enrolled continually for 5 years -- increased from from 1.0% in 2008 to 1.6% in 2012 among those aged 50 and up. (Data for the other years was not available.)

Among other age groups, annual incidents rose from 0.2% in 2008 to 0.3% in 2012 among participants ages 18–39 and from 0.4% to 0.7% in those ages 40-49.

"As known historically, women tend to have more dry eye," Bradley said, and the findings reflect this: Among women, the incidence rate grew from 0.8% to 1.2%, and among men, it went from 0.3% to 0.6%.

Annual prevalence, measured for the years 2005 and 2012, increased from 0.1% to 0.6% in those participants ages 18–39, from 0.5% to 1.9% in those ages 40–49, and from 1.8% to 6.0% in those ages 50 and up. The annual prevalence figures were calculated in beneficiaries who were enrolled for 2 years before and after.

The researchers calculated overall prevalence -- 5.3% -- based on at least two indicators of dry eye disease between 2003 and 2015. The rates were higher in women (7.8% vs. 3.0% in men) and higher in older people (11.7% in those 50 and older versus 5.7% in those ages 40-49, 2.0% in those ages 18-39, and 0.2% in those ages 2-17).

Bradley said he saw many of dry eye disease cases while working at military clinics. "You prescribe artificial tears and other treatments," he said. "Sometimes tests are done, sometimes they are not done. Generally speaking, testing is probably not done as much as it could be."

How are these cases treated? Over-the-counter artificial tears are one option, Bradley said. "But they're not a drug. They're designed to replenish your natural tears."

Restasis -- cyclosporine ophthalmic emulsion -- is also available. "It's designed to actually produce more tears," Bradley said.

While these options often successfully treat mild and moderate dry eye disease, he said, "there haven't been many treatment options for the more severe population."

Earlier this year, the , an adhesion molecule inhibitor formulated as a topical ophthalmic solution for treating dry eye disease. The drug is heavily advertised at the American Academy of Optometry meeting, and manufacturer Shire sponsored Bradley's study.

  • author['full_name']

    Randy Dotinga is a freelance medical and science journalist based in San Diego.

Disclosures

The study was funded by Shire, the maker of Xiidra. Bradley reports no relevant disclosures.

Primary Source

American Academy of Optometry

Bradley J, et al "Estimates of incidence and prevalence of dry eye disease across age froups in the U.S. using data from a large healthcare system" AAOPT 2016.