Incidence of dry eye in an older population

Objectives: To estimate the 5-year incidence of dry eye and to examine its association with risk factors. Methods: The population of Beaver Dam, Wis, that was 43 to 84 years of age (n=5924) was examined in the 1988-1990 (n=4926), 1993-1995 (n=3722), and 1998-2000 study phases (n=2962). At the 1993-1995 examination, when dry eye data were first collected, and the 1998-2000 examination, 2783 subjects participated, and 44 were interviewed. Of these, 2802 provided dry eye history. The incidence cohort consisted of 2414 subjects not reporting dry eye in the 1993-1995 examination. Risk factor information was ascertained at the 1993-1995 examination and included demographics, medical history, cardiovascular disease risk factors, medications, and lifestyle factors. Results: During the 5-year interval between examinations, a history of dry eye developed in 322 of 2414 subjects, for an incidence of 13.3% (95% confidence interval [CI], 12.0%-14.7%). Incidence was significantly associated with age (P<.001). After adjusting forage, incidence was greater in subjects with a history of allergy or diabetes, who used antihistamines or diuretics, and with poorer self-rated health (P<.05). Age-adjusted incidence was less in subjects using angiotensin-converting enzyme inhibitors or consuming alcohol (P<.05). It was not significantly associated with sex, blood pressure, hypertension, serum total or high-density lipoprotein cholesterol level, body mass index, history of arthritis, gout, osteoporosis, cardiovascular disease, thyroid disease, or smoking, and use of caffeine, vitamins, antianxiety medications, antidepressants, calcium channel blockers, or anticholesterolemics. Conclusions: Incidence of dry eye is substantial. However, there are few associated risk factors. Some drugs (eg, diuretics and antihistamines) are associated with a greater risk, whereas others (angiotensin-converting enzyme inhibitors) are associated with lower risk.