Estimating the prevalence of dry eye among elderly Americans: See project

Purpose. To provide the first population-based data on the prevalence of dry eye in the United States. Methods. 2,514 subjects, age 65 and older, drawn from the Medicare enrollment files in Salisbury, Maryland, of whom 2,425 responded to a dry eye questionnaire and underwent standardized Rose Bengal (RB) grading (0-9) and Schirmer's testing. Results. 11.3% had RB scores ≥5, and 11.9% had Schirmer's ≤5. A definition of dry eye based on symptoms alone (1 or more out of 6 symptoms reported all the time or often) yielded a prevalence of 14.6%; symptoms and an RB score ≥5, a prevalence of 2.0%; symptoms and a Schirmer's ≤5, a prevalence of 2.2%; and symptoms plus RB ≥5 or Schirmer's ≤5, a prevalence of 3.5%. For none of these definitions were there age-, gender-, or race-specific differences in prevalence. Conclusions. The prevalence of dry eye varies widely depending on definitional criteria, and there is minimal overlap between individuals identified as having dry eye by symptoms, Schirmer's, or RB testing.