July 11, 2018
2 min read

Findings validate link between environmental factors, dry eye

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Joanne Shen
Joanne F. Shen

Dry eye signs and symptoms worsened in the presence of a high pollen count, high wind speed low humidity and high pollution, according to a study presented at the Association for Research in Vision and Ophthalmology meeting.

Researchers analyzed a subset of data from the Dry Eye Assessment and Management study to evaluate the association between dry eye signs and symptoms and a variety of environmental factors.

Participants included 535 adults with moderate to severe dry eye. They completed the Ocular Surface Disease Index (OSDI), Brief Ocular Discomfort Index (BODI), conjunctival lissamine green staining, corneal fluorescein staining, tear film break-up time and a 5-minute Schirmer’s test with anesthesia, in addition to clinical evaluations.

The researchers collected same-day environmental data, such as average temperature, humidity, wind speed, dew point, ozone, toxic and poisonous gas, pollen, and air pollution.

Of the dry eye symptoms, the OSDI subscale of environmental triggers were inversely correlated with humidity and total pollen count, according to researchers.

BODI was correlated with total pollen count.

Of dry eye signs, corneal fluorescein dye staining was inversely correlated with humidity. TBUT was positively correlated with both humidity and dew point but was inversely correlated with aerosol optical depth (an air pollution equivalent).

Of dry eye signs, lissamine green and Schirmer’s tests had no statistical correlation to weather, pollution and pollen, but TBUT and, to a lesser degree, corneal staining were associated with environmental factors, researchers wrote.

“The DREAM study allowed us to prospectively study a large geographically diverse dry eye population and examine the correlation of severity between weather and pollution factors and dry eye symptoms and signs,” researcher Joanne F. Shen, MD, told Primary Care Optometry News.

“Our findings were consistent with other retrospective studies which have found correlation between environmental factors and dry eye symptoms and signs,” she continued. “TBUT was highly correlated to dew point and humidity, confirming what we clinicians have always suspected: Move to a humid climate if you have dry eyes. Given these findings, it is important to consider employing strategies designed to control environmental triggers for dry eye patients.

“Due to seasonality, these correlations should be taken into consideration when designing dry eye studies less than 1 year in duration,” Shen concluded. – by Abigail Sutton


Shen JF, et al. Environmental factors and symptoms and signs of dry eye disease at baseline in the Dry Eye Assessment and Management Study. Presented at: Association for Research in Vision and Ophthalmology; Honolulu; April 29-May 3, 2018.

Disclosures: Shen reported no financial disclosures. Please see the full study for all remaining authors’ financial disclosures.