Dry eye disease (DED) is one of the most prevalent eye conditions, affecting millions of people globally. The worldwide prevalence ranges from 5% to 50%, depending on the geographic region¹. DED is defined as a multifactorial eye disease related to loss of the tear film homeostasis. Instability and hyperosmolarity of the tear film leads to damage to the ocular surface, which is associated with ocular symptoms ². DED may cause a wide range of ocular symptoms including redness, dryness, discomfort, itching, stinging, burning, irritation, pain, photophobia and foreign body sensation ^[2,3]. This is typically accompanied by fluctuating vision with blurred or double vision ^[4,5]. These symptoms can significantly impact patients’ quality of life and lead to reduced work and learning efficiency ^[4,6]. Patients with DED also have a greater risk of suffering from mental health disorders such as depression and anxiety ^[7,8]. Despite this, many people with DED remain unevaluated, undiagnosed, and untreated, especially among the young population ^[9,10].

However, the extended use of digital display terminals (DDTs), such as computers, smartphones, or tablets, is considered to be a key risk factor for DED, mainly through impaired blinking patterns ^[11]

Studies indicate that dry eye affects a significant portion of the global population. A 2017 National Health and Wellness Survey found that 6.8% of U.S. adults had a DED diagnosis. A meta-analysis of US studies estimated a pooled prevalence of 8.1%. 

Demographic Factors: Age: DED prevalence increases with age, particularly after 40. Some studies show a significant increase in older adults.  Sex: Women are generally reported to have a higher prevalence of DED than men. Ethnicity: Some studies suggest higher prevalence in individuals of East Asian descent^. Advanced age, female sex and East Asian ethnicity have been identified as key non-modifiable demographic features predisposing individuals to dry eye disease. Systemic conditions that have been associated with an increased risk of dry eye disease include migraine, Sjögren syndrome, connective tissue disorders, mental health disorders, diabetes mellitus and androgen deficiency. Medications that may contribute to this risk include antidepressants, antihistamines, and hormone replacement therapy. Ocular and iatrogenic risk factors of dry eye disease include blepharitis, Demodex infestation, ocular surgery, blink completeness, contact lens wear, and topical ophthalmic medications. A range of modifiable lifestyle factors that can increase the risk of dry eye disease have also been identified, including low humidity environments, digital screen use, quality of sleep, diet, and eye cosmetic wear. Dry eye is a common disease affecting millions globally.

AIMS & OBJECTIVE

To Evaluate the prevalence and severity of dry eye in post-menopausal women presenting to our hospital. And to assess the prevalence of various types of dry eye in post-menopausal women

The study was conducted in a tertiary hospital. After obtaining institutional ethical committee approval It was a Observational prospective study conducted on 160 patients with all post-menopausal women in the department of Ophthalmology, at a tertiary care centre, from April 2024 to November 2024. The institute Ethics Committee approval was obtained before starting the sample collection. A written and informed consent was taken from the patient regarding the study in his/her vernacular language and English. In this study Patients were subjected to: A detailed history of sign & symptoms and its duration. Detailed history of systemic diseases and its duration, medication were noted. Patients were subjected to General physical examination, and ocular examination.

2.1. Study period (April 2024 to November 2024).

2.2. Ethical consideration the study was started after getting clearance from institutional ethics committee. Written informed consent was taken before the procedure.

2.3. In Study population only those post-menopausal women considered who attending the out-patient department of ophthalmology.

2.4. Inclusion criteria All Women who have attained menopause at least 1 year ago were considered.

2.5. Exclusion criteria 1. Previous history of ocular trauma or surgery were not considered.

2. Patients with ocular surface disorders
3. Patients on long term topical medications 4. Patients with any systemic disease known to cause dry

Statistics and analysis of data

 Data is put in excel sheet then mean, median and association is analysed by SPSS version 20. Chi-square test was used as test of significance for qualitative data. Continuous data was represented as mean and SD. MS Excel and MS word was used to obtain various types of graphs such as bar diagram. P value (Probability that the result is true) of P value <0.05 was considered as statistically significant after assuming all the rules of statistical tests. Statistical software: MS Excel, SPSS version 22 (IBM SPSS Statistics, Somers NY, USA) was used to analyse data. Sample size is calculated by N master statistical software.

130 post-menopausal women who fulfilled eligibility criteria were included in the study.89 participants were found to have dry eye disease in this study . The Table 1 revealed  the trend of increasing prevalence of dry eye disease with increasing age in post-menopausal women. The women in 66- 70 age group had the highest prevalence among all the participants in this study Redness, grittiness & burning were among the most common complaints.

In this study of 130 post-menopausal women, 10 (7.69%) patients had evaporative type   of dry eye, 12 (9.23%) had aqueous deficiency type and 19 (14.61 %) had mixed variety   type of dry eye.

Table 1: Age-group distribution of dry eye in the study group Age.

Figure No: 1

In this study we find out that prevalence, severity, various symptoms and types of dry eye in post-menopausal female population of our hospital OPD. In this study, a total of 130 females of post-menopausal age group were examined out of whom only 89 (68.46%) had dry eye. The prevalence was as high as 65% in a recent study published by Banik et al. in 2018, wherein they studied dry eye among both male & female subjects from Eastern India. 4 This difference could be because of various climatic and occupational differences. (Table 2 )shown it .

Table No2: Severity of grades of dry eye

Dry eye is classified into mild, moderate & severe grades depending on various factors like age gender and geographical condition. In this study their respective prevalence was 10, 12 & 19 . Mild dry eye was the commonest whereas severe dry eye was a rare occurrence. It has also been seen that   68% of females complaining of dry eye symptoms did not test positive in any of the three tests conducted (TBUT, Rose Bengal staining and Schirmer Test.

Tear film insufficiency, also known as dry eye disease, occurs when the tear film is unable to adequately lubricate and protect the eye's surface. This can happen due to a reduction in tear production, abnormal tear composition, or issues with tear distribution. The tear film is composed of three layers: a lipid layer, an aqueous layer, and a mucin layer, and dysfunction in any of these layers can lead to tear film insufficiency. There are 2 types of dry eye. First, the aqueous deficient dry eye which occurs due to reduced production of tears and the second is evaporative type of dry eye which occurs when there is increased evaporation of the normal volume of tears. Either of the two can give rise to a hyperosmolar tear film which is responsible for various symptoms of dry eye. These symptoms can be mild initially, but with continued progression of the disease and absence of treatment, they can worsen and affect the quality of life adversely.

In this study we  find out that prevalence, severity, various symptoms and types of dry eye in post-menopausal female population of our hospital OPD. In this study, a total of 130 females of post-menopausal age group were examined out of whom only 89 (68.46%) had dry eye. The prevalence was as high as 65% in a recent study published by Banik et al. in 2018, where in they studied dry eye among both male & female subjects from Eastern India. 4 This difference could be because of various climatic and occupational differences.

Worldwide, dry eye disease (DED) is emerging as an important cause of ocular morbidity. In different population-based studies, the prevalence of DED ranges from 5 to 50%.[¹²] .

In our study majority of post menopausal women suffered of dry  who are more than 60 years  similar study was found in A retrospective study conducted at Miami and Broward Veterans Affairs eye clinics estimated a prevalence of 22% DED in females compared to 12% in males.^[13] A study conducted in Korea reported a prevalence of 33.2%.^[14] The overall prevalence of dry eye among patients of age 40 years and above in our study population is 54.3% which is quite higher than that found in other similar studies. This may reflect the effect of tropical whether conditions in our area of study and other population characteristics of the study population. Another reason for this disparity among the reported prevalence among various studies may be a lack of standardized diagnostic definition.

Dry eye is classified into mild, moderate & severe grades depending on various factors like age gender and geographical condition. In this study their respective prevalence was 10, 12 & 19 . Mild dry eye was the commonest whereas severe dry eye was a rare occurrence. It has also been seen that   68% of females complaining of dry eye symptoms did not test positive in any of the three tests conducted (TBUT, Rose Bengal staining and Schirmer Test).

In a similar kind of study done in patients of all ages & both sexes, it was found that 48% of patients complaining of dry eye did not have evidence of dry eye when tested similar to our study ^{[15] .} Dry eye is more common in women than men (due to female hormonal effects on the lacrimal and Meibomian glands and ocular surface) and has an increased prevalence with age.^[16] Studies have shown that female gender is a risk factor in developing dry eye, with a prevalence that ranges from 12% to 22%.^[17] The prevalence of DED worldwide varies depending on the diagnostic criteria employed, which ranges from approximately 5% to 50% in population-based studies..

In this study it was found that Dry eye disease is a significant concern for postmenopausal women, with studies indicating a high prevalence. The hormonal changes during menopause, particularly the decline in oestrogen, are a major factor in the development of dry eye symptoms. Early diagnosis and effective treatment are crucial to improve quality of life and prevent potential visual impairment. Age is a significant factor, with the prevalence and severity of dry eye increasing with age. he severity of dry eye symptoms can range from mild to severe, with some women experiencing significant visual impairment. Dry eye can significantly impact a woman's quality of life, causing discomfort, pain, and visual disturbances.

It can also lead to difficulties with everyday activities, such as reading, driving, and using a computer. Early diagnosis and treatment can improve quality of life and prevent severe vision loss. A multidisciplinary approach involving gynaecologists and ophthalmologists may be beneficial in managing dry eye in postmenopausal women. 

SOURCE OF FUNDING

^NO

 CONFLICT OF INTEREST

The authors report no conflicts of interest.

 SUBMISSION DECLARATION

This submission has not been published anywhere previously and that it is not simultaneously being considered for any other

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