Importance of tear film instability in dry eye disease in office workers using visual display terminals: The osaka study

Norihiko Yokoi, Miki Uchino, Yuichi Uchino, Murat Dogru, Motoko Kawashima, Aoi Komuro, Yukiko Sonomura, Hiroaki Kato, Kazuo Tsubota, Shigeru Kinoshita

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Purpose To evaluate the relationship between subjective symptoms and clinical signs in dry eye disease (DED) in office workers using visual display terminals (VDTs). Design Cross-sectional study. Methods This study involved 672 Japanese young and middle-aged office workers who use VDTs. The subjects completed questionnaires designed to detect subjective symptoms and risk factors for DED. Dry eye tests, including tear film break-up time (TBUT), corneal-conjunctival staining with fluorescein and lissamine green, and the Schirmer test, were performed. Based on the Japanese diagnostic criteria for DED, the subjects were classified into 3 groups: definite DED, probable DED, and non-DED. Between each group, subjective symptoms and clinical signs were compared. Results Of the 672 subjects, 561 (374 male, 187 female) completed the questionnaire (response rate: 83.5%). Definite DED was diagnosed in 65 subjects (11.6%), probable DED in 303 subjects (54.0%), and non-DED in 193 subjects (34.4%). The mean subjective symptom score was significantly less in subjects with probable DED (2.05 ± 0.42) and non-DED (1.63 ± 0.38) than in those with definite DED (2.19 ± 0.40) (P <.05 and P <.01, respectively). In the subjects with probable DED, a subgroup with positive subjective symptoms and abnormal TBUT (≤5 seconds) was categorized as short TBUT-type DED, and it was found that they had a higher subjective symptom score (2.09 ± 0.40), equivalent to that of those with definite DED (P =.269). Conclusions Despite no or minor epithelial damage, the severity of subjective symptoms was greater in short TBUT-type DED, most likely attributable to tear film instability. Thus, it might prove important to evaluate TBUT to successfully treat those patients.

Original languageEnglish
Pages (from-to)748-754
Number of pages7
JournalAmerican Journal of Ophthalmology
Volume159
Issue number4
DOIs
Publication statusPublished - 2015 Apr 1

ASJC Scopus subject areas

  • Ophthalmology

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