title: Prevalence and risk factors of dry eye syndrome in a United States veterans affairs population.
abstract: OBJECTIVE
  To evaluate the prevalence of dry eye syndrome (DES) and its associated risk factors in a US Veterans Affairs population receiving ocular care services.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  settings: Patients were seen in the Miami and Broward Veterans Affairs eye clinics between 2005 and 2010. patients population: Patients were divided into cases and controls with regard to their dry eye status (cases = ICD9 code for DES plus dry eye therapy; controls = patients without ICD9 code plus no therapy). main outcome measures: The prevalence of DES and its associated risk factors.
  
  
  RESULTS
  A total of 16 862 patients were identified as either a dry eye case (n = 2056) or control (n = 14 806). Overall, 12% of male and 22% of female patients had a diagnosis of DES, with female gender imparting a 2.40 increased risk (95% confidence interval [CI] 2.04-2.81) over male gender. Several medical conditions were found to increase DES risk including post-traumatic stress disorder (odds ratio [OR] 1.97, 95% CI 1.75-2.23), depression (OR 1.91, 95% CI 1.73-2.10), thyroid disease (OR 1.81, 95% CI 1.46-2.26), and sleep apnea (OR 2.20, 95% CI 1.97-2.46) (all analyses adjusted for gender and age). The use of several systemic medications, including anti-depressant medications (OR 1.97, 95% CI 1.79-2.17), anti-anxiety medication (OR 1.74, 95% CI 1.58-1.91), and anti-benign prostatic hyperplasia medications (OR 1.68, 95% CI 1.51-1.86), was likewise associated with an increased risk of DES.
  
  
  CONCLUSIONS
  The prevalence of DES was found to be high in both men and women in our eye care population. This is the first study to demonstrate that in a veteran population, several diagnoses were significantly associated with DES, including post-traumatic stress disorder and depression.
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida; Miami Veterans Administration Medical Center, Miami, Florida. Electronic address: agalor@med.miami.edu.
authors.forename: Anat
authors.initials: A
authors.lastname: Galor
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida.
authors.forename: William
authors.initials: W
authors.lastname: Feuer
authors.affiliation: Department of Epidemiology and Public Health, University of Miami, Miami, Florida.
authors.forename: David J
authors.initials: DJ
authors.lastname: Lee
authors.affiliation: Department of Endocrinology and Geriatrics, University of Miami, Miami, Florida; Miami Veterans Administration Medical Center, Miami, Florida.
authors.forename: Hermes
authors.initials: H
authors.lastname: Florez
authors.affiliation: Miami Veterans Administration Medical Center, Miami, Florida.
authors.forename: David
authors.initials: D
authors.lastname: Carter
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida; Miami Veterans Administration Medical Center, Miami, Florida.
authors.forename: Bozorgmehr
authors.initials: B
authors.lastname: Pouyeh
authors.affiliation: Miami Veterans Administration Medical Center, Miami, Florida.
authors.forename: William J
authors.initials: WJ
authors.lastname: Prunty
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida.
authors.forename: Victor L
authors.initials: VL
authors.lastname: Perez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003866:Depressive Disorder / Q000453:epidemiology; D064420:Drug-Related Side Effects and Adverse Reactions; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D013959:Thyroid Diseases / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*; D055815:Young Adult