title: Associations of systemic diseases, smoking and contact lens wear with severity of dry eye.
abstract: OBJECTIVE
  Systemic diseases, smoking, ocular surgeries and contact lens wear have been linked with dry eye but it is not known if these factors are also associated with severity of dry eye. A cross-sectional investigation was conducted on the effect of various systemic and ocular conditions with respect to the severity of dry eye in Asian patients.
  
  
  METHODS
  Prospective recruitment of consecutive new referral patients from a dry eye clinic was performed. Medical history, dry eye symptoms and clinical assessment were coded in a standardised form and analysed.
  
  
  RESULTS
  Out of 510 patients (25% men), mean ± S.D. age 53.0 ± 14.1 years, 25 had previous diagnosis of rheumatoid arthritis, 30 had diabetic mellitus, 41 had thyroid disease, and 33 were current smokers; 23 and 41 patients had previous LASIK and cataract surgery respectively and 90 were current contact lenses wearers. A previous diagnosis of rheumatoid arthritis was associated with more severe superior corneal fluorescein staining (OR = 11.2, 95% CI 4.6-27.4).
  
  
  CONCLUSIONS
  Generally, with the exception of rheumatoid arthritis, there were no associations between dry eye severity and systemic diseases, smoking, previous ocular surgeries and contact lens wear. Dry eye patients with rheumatoid arthritis tend to have more severe ocular surface damage in the superior cornea.
authors.affiliation: Singapore Eye Research Institute, National University of Singapore, Singapore.
authors.forename: Sze-Yee
authors.initials: SY
authors.lastname: Lee
authors.forename: Andrea
authors.initials: A
authors.lastname: Petznick
authors.forename: Louis
authors.initials: L
authors.lastname: Tong
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications*; D002387:Cataract Extraction / Q000009:adverse effects; D003261:Contact Lenses / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000150:complications*; D015352:Dry Eye Syndromes / Q000209:etiology*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects*; D013959:Thyroid Diseases / Q000150:complications*