title: A questionnaire-based assessment of symptoms associated with tear film dysfunction and lid margin disease in an Asian population.
abstract: OBJECTIVE
  To study the prevalence, associated factors and impact of symptomatic dry eye in an Asian population.
  
  
  METHODS
  A population based survey of eye diseases in 3,280 (78.7% response rate) Malay persons aged 40-80 selected from designated areas in southwestern Singapore. Participants were administered a standardized dry eye questionnaire consisting of 6 questions on symptoms, and had a comprehensive systemic and ocular examination. Symptoms of tear film dysfunction (STFD) was defined as one or more self-reported symptoms that were frequently present (ranked often or all the time).
  
  
  RESULTS
  The prevalence rate of STFD was 6.5% (95% confidence interval [CI]: 5.7, 7.4). The prevalence was significantly higher in men compared to women (8.2% and 4.9%, respectively; p < 0.001) and decreased with age in men (p = 0.002) but not in women (p = 0.101). After adjusting for age, gender, nature of work (outdoor/indoor), and housing type, factors significantly associated with STFD were cigarette smoking (odds ratio [OR] 1.77, 95% CI: 1.17-2.66), thyroid disease (OR 2.58; 95% CI: 1.29-5.18) and higher income (OR 1.74; 95% CI: 1.13-2.68). STFD were associated with self-reported difficulty in performing daily activities (work, family and leisure related) (p = 0.006).
  
  
  CONCLUSIONS
  STFD are present in 6.5% of Singapore Malay adults and is associated with cigarette smoking, presence of thyroid disease and a reduced visual function-related quality of life.
authors.affiliation: Singapore National Eye Center, Singapore.
authors.forename: Louis
authors.initials: L
authors.lastname: Tong
authors.forename: Louis
authors.initials: L
authors.lastname: Tongg
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.forename: Ecosse L
authors.initials: EL
authors.lastname: Lamoureux
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
authors.forename: Mohamad
authors.initials: M
authors.lastname: Rosman
authors.forename: Donald T H
authors.initials: DT
authors.lastname: Tan
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000453:epidemiology*; D005141:Eyelid Diseases / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires