title: Ethnic differences in dry eye symptoms: effects of corneal staining and length of contact lens wear.
abstract: OBJECTIVE
  To explore the relationships among length of contact lens (CL) wear, degree of corneal staining and severity of dryness symptoms, and to determine whether these relationships differ between Asians and non-Asians.
  
  
  METHODS
  Adapted soft CL wearers (n=395; 180 Asian, 215 non-Asian) were required to discontinue CL wear for at least 24h and report to the University of California, Berkeley Clinical Research Center (UCB-CRC). Fluorescein corneal staining was graded according to Brien Holden Vision Institute scales. Length of CL wear was reported by subjects and subjective dryness ratings were collected using the UCB-CRC Dry Eye Flow Chart (DEFC).
  
  
  RESULTS
  More Asian CL wearers exhibited corneal staining compared to non-Asians, and Asian CL wearers had a higher mean grade of corneal staining (p<0.001), as well as a higher mean DEFC classification (p<0.001). The difference between Asians and non-Asians in grades of corneal staining extent and depth were significant (p<0.001). Among non-Asian CL wearers, dryness symptoms decreased with more years of CL wear and increased in the presence of corneal staining, which was not the case for Asian CL wearers.
  
  
  CONCLUSIONS
  Asian soft CL wearers reported more severe dryness symptoms and demonstrated more severe corneal staining overall compared to non-Asians. Among non-Asians, dryness symptoms were less severe on average with increased years of CL wear and more severe in the presence of corneal staining. Dryness severity does not appear to be related to years of CL wear or corneal staining among Asians.
authors.affiliation: Clinical Research Center, School of Optometry, University of California at Berkeley, United States.
authors.forename: Nina
authors.initials: N
authors.lastname: Tran
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Graham
authors.forename: Meng C
authors.initials: MC
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D001213:Asian / Q000706:statistics & numerical data*; D002140:California / Q000453:epidemiology; D015984:Causality; D003261:Contact Lenses / Q000706:statistics & numerical data*; D003315:Cornea / Q000473:pathology*; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000208:ethnology*; D005260:Female; D015590:Fluorophotometry / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013194:Staining and Labeling; D055815:Young Adult
keywords: Asians; Comfort; Contact lens-induced dry eye; Dryness; Ethnicity; Race; Soft contact lenses