Dry eye disease affects women at a disproportionately higher rate than men. It has a substantial negative impact on those affected, and on healthcare systems. Its impact is wide-reaching, including those affected and the healthcare systems that care for them.
Types, risks of DED
There are two types of DED—aqueous-deficient and evaporative. Evaporative DED is more common than aqueous-deficient dry eye, but more than one-third of patients will have a combination of both types.8
Risk factors for DED development are myriad and can be environmental (use of air conditioning/fans, exposure to smoking, low humidity, dry climates, and windy conditions) or medical (blood pressure medications, antidepressants, glaucoma medications, rheumatoid arthritis, and Sjögren’s syndrome, lupus, diabetes, among others).9
Eye surgeries (LASIK and cataract removal) and contact lens wear can lead to the development of DED as well. About 30% of the 140 million people who wear contact lenses worldwide discontinue use due to dryness and eye discomfort. People who wear contacts are four times more likely to develop DED than those who do not.2
One of the greatest risk factors, however, is gender. DED is more common in women than men, particularly in women with autoimmune disease who are over age 50.2 Women also are diagnosed with DED at a younger age than men.
Two large epidemiological studies in North America, the Women’s Health Study and the Physician’s Health Studies, showed a statistically significant, age-adjusted 70% increase in risk of DED among women.
The Beaver Dam Study showed that the prevalence of DED is 50% higher among women than men.10 This is likely due to the decrease in natural tear production that occurs from hormonal changes from pregnancy, use of birth control pills, or menopause.
Trattler et al. found that the incidence of DED was higher than anticipated in a real-world setting of patients scheduled to undergo cataract surgery; while patients showed clinical signs of DED and 22% had been previously diagnosed with DED, 30% had at least occasional complaints. 11
DED impacts more women, who experience symptoms and pain that are more severe.
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