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Prevalence of dry eye disease (DED) and associated risk factors in 16 Northern Palestinian West Bank towns: a cross-sectional study

Poster Details


Co Author(s):    R. Shehada                    

Abstract Details


DED is a multifactorial disease of the interpalpebral ocular surface and tear film that leads to discomfort, fatigue and disturbance in vision. DED affects patients’ quality of life and leads eventually to loss of productivity. Moreover, it has a considerable socioeconomic burden. It is a growing underdiagnosed health issue and the possible associated risk factors are very common and keep growing worldwide. The objective of this study is to assess the prevalence of DED and potential associated risk factors in the Northern West Bank towns


A cross sectional study was conducted on 769 volunteers who were recruited by holding free medical days in municipal councils in 16 selected towns in Northern West Bank governorates during September/2015-January/2016


Participants were enrolled after informed consent was obtained. Multistage sampling based on the Palestinian Central Bureau of Statistics was used.Trained interviewers assessed DED symptoms using a six-item questionnaire. Slit-lamp examinations consisting of tear film breakup time (TBUT), fluorescein corneal staining (FL/S), and Schirmer test. Depending on the literature, DED was diagnosed by having one or more DED symptoms (foreign body sensation, burning sensation, photophobia, red eye, itchy eye, teary eye) all or most of the time accompanied by at least one sign in the worse eye: TBUT ≤ 10 seconds,Schirmer score ≤ 5 mm, FL/S ≥ grade 1


The mean age was 43.6 ranging from 15-90 years with 52.7% females. The prevalence of DED was 54.9%. All of the DED cases reported having one or more DED symptoms all or most of the time. Of DED cases, 96% had a TBUT of ≤10s, 8.8% had Schirmer test results of ≤ 5, 89.6% had FL/S of the cornea of ≥ grade 1 and 88.2% had MG disease. Regression results revealed that DED was more prevalent in females [57.6%] compared to males [42.4%], (OR:1.5;95%CI 1.019-2.019) p≤0.05, and among those with conjunctivitis (OR:2.7;95% CI 1.544-4.866) p-value<0.001 but not associated with age.


DED is highly prevalent with sex and previous and current history of conjunctivitis to be significantly associated with developing DED. Difference in sex might be related to hormonal effects on the lacrimal gland, goblet cell function, MG and ocular surface sensitivity. Regarding conjunctivitis; the result could be explained due to continuous allergy and inflammation leading to excessive evaporation of tear film causing more probably evaporative DED. It is recommended to increase public awareness in society and to conduct further researches to better understand the risk factors associated with DED

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