Short tear film breakup time-type of dry eye in India

PURPOSE: The aim of this study was to describe the clinical characteristics and risk factors of short tear film break-up time (TBUT) type of dry eye disease and compare it with other types of dry eye diseases. METHODS: This cross-sectional study included 570 patients (≥ 20 years) from the outpatient department using systematic random sampling. RESULTS: The age-adjusted prevalence of short TBUT type of dry eye disease was 5.4% (95% confidence interval: 3.2–6.8%). There was no difference (P > 0.05) between the total and subscale scores of the Ocular Surface Disease Index(®) questionnaire between patients with short TBUT and those with aqueous tear deficiency. Both these groups differed significantly (P < 0.05) in the findings of TBUT, Schirmer I test, and Lissamine green staining score. The common symptoms in patients with short TBUT type of dry eye disease were eye fatigue (25.4%), heaviness in the eye (19.7%), and an uncomfortable sensation (14.1%). The symptoms in the aqueous tear deficiency group were light sensitivity (28.2%), dryness (19.2%), burning (13.0%), foreign body sensation (12.8%), and blurring of vision (14.1%). The risk factors associated with short TBUT type of dry eye disease were the presence of meibomian gland dysfunction (odds ratio: 3.759 [95% confidence interval: 2.135–6.618], P < 0.0001) and female sex [odds ratio: 1.954 (95% confidence interval: 1.042–3.667), P = 0.037]. CONCLUSION: Patients with short TBUT type of dry eye disease have symptom severity similar to aqueous tear-deficient dry eyes, but the pattern is different. The finding of this type of dry eye disease in India indicates its global presence, and ophthalmologists should consider it in their differential diagnoses.