Possible association between subtypes of dry eye disease and seasonal variation - PubMed
- ️Sun Jan 01 2017
Possible association between subtypes of dry eye disease and seasonal variation
Masahiko Ayaki et al. Clin Ophthalmol. 2017.
Abstract
Purpose: The purpose of this study was to evaluate the influence of seasons on the signs and symptoms of dry eye disease (DED).
Methods: This is a cross-sectional, case-control study, and participants were non-DED subjects (n=1,916, mean age 54.4±14.4 years) and DED patients (n=684, 54.2±12.1 years) visiting six eye clinics at various practices and locations in Japan. We evaluated the signs and symptoms of DED and the seasons with the most severe results were compared to those with the least severe results in both groups. Main outcome measures were differences in the severity of the signs and symptoms of DED between the most and least severe seasons.
Results: The majority of DED symptoms were most severe during spring and least severe in summer. Significant differences between these two seasons were found for irritation (P=0.001), pain (P=0.007), blurring (P=0.000), and photophobia (P=0.007) in the DED group. Superficial punctate keratopathy (P=0.001) and tear break-up time (BUT; P=0.000) results also indicated that DED was most severe in spring. In contrast, fewer patients had low Schirmer test results in spring, although this was not statistically significant (P=0.061).
Conclusion: Our results demonstrated that the severity of DED is seasonal, which may explain the increase of short BUT-type DED cases observed in spring when air pollen counts are highest.
Keywords: air pollen; allergic conjunctivitis; cornea; dry eye disease; hay fever; ocular surface; seasonality; tear break-up time; tear production.
Conflict of interest statement
Disclosure The authors report no conflicts of interest in this work.
Figures

Presence of DED-related symptoms in (A) non-DED and (B) DED patients. Seasonal variation was observed for irritation, pain, blurring, and photophobia in DED patients, with symptoms being most severe in spring. Seasonal variation was also observed in the non-DED subjects, with symptoms being least severe in summer. There was no significant variation in the severity of symptoms between summer, fall, and winter in the non-DED subjects. *P<0.05 when the season with the most severe symptoms was compared to the season with the least severe symptoms (chi-square test). Abbreviation: DED, dry eye disease.

Presence of DED-related signs in (A) non-DED and (B) DED patients. Seasonal variation was observed in BUT and SPK in the DED patients. Seasonal variation in all signs except for the Schirmer test was observed in the non-DED subjects. *P<0.05 when the season with the most severe symptoms was compared to the season with the least severe symptoms (chi-square test). Abbreviations: BUT, tear break-up time; DED, dry eye disease; MBI, maximum blinking interval; SPK, superficial punctuate keratitis.
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