title: Prevalence of dry eye disease in visual display terminal workers: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the prevalence and risk factors of dry eye disease (DED) in workers using visual display terminals (VDT).
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  We searched PubMed, Cochrane Library, Embase and Science Direct databases for studies reporting DED prevalence in VDT workers.
  
  
  RESULTS
  16 of the 9049 identified studies were included, with a total of 11,365 VDT workers. Despite a global DED prevalence of 49.5% (95% CI 47.5 to 50.6), ranging from 9.5% to 87.5%, important heterogeneity (I(2)=98.8%, p<0.0001) was observed. Variable diagnosis criteria used within studies were: questionnaires on symptoms, tear film anomalies and corneoconjunctival epithelial damage. Some studies combined criteria to define DED. Heterogeneous prevalence was associated with stratifications on symptoms (I(2)=98.7%, p<0.0001), tears (I(2)=98.5%, p<0.0001) and epithelial damage (I(2)=96.0%, p<0.0001). Stratification of studies with two criteria adjusted the prevalence to 54.0% (95% CI 52.1 to 55.9), whereas studies using three criteria resulted in a prevalence of 11.6% (95% CI 10.5 to 12.9). According to the literature, prevalence of DED was more frequent in females than in males and increased with age.
  
  
  CONCLUSIONS
  Owing to the disparity of the diagnosis criteria studied to define DED, the global prevalence of 49.5% lacked reliability because of the important heterogeneity. We highlight the necessity of implementing common DED diagnostic criteria to allow a more reliable estimation in order to develop the appropriate preventive occupational actions.
authors.affiliation: University Hospital of Clermont-Ferrand (CHU), Department of Ophthalmology, Clermont-Ferrand, France University Hospital of Clermont-Ferrand (CHU), Preventive and Occupational Medicine, Clermont-Ferrand, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Courtin
authors.affiliation: University Hospital of Clermont-Ferrand (CHU), Clinical Research Direction, Clermont-Ferrand, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pereira
authors.affiliation: Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Australia.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Naughton
authors.affiliation: University Hospital of Clermont-Ferrand (CHU), Preventive and Occupational Medicine, Clermont-Ferrand, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Chamoux
authors.affiliation: University Hospital of Clermont-Ferrand (CHU), Department of Ophthalmology, Clermont-Ferrand, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Chiambaretta
authors.affiliation: University Hospital of Clermont-Ferrand (CHU), Preventive and Occupational Medicine, Clermont-Ferrand, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Lanhers
authors.affiliation: University Hospital of Clermont-Ferrand (CHU), Preventive and Occupational Medicine, Clermont-Ferrand, France University Hospital of Clermont-Ferrand (CHU), Clinical Research Direction, Clermont-Ferrand, France Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Australia University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions EA3533, Clermont-Ferrand, France Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France CNRS UMR 6024, Psychological & Psychosocial Stress Team, Clermont-Ferrand, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dutheil
mesh_terms: D000328:Adult; D016288:Computer Terminals; D015352:Dry Eye Syndromes / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects*; D009790:Occupations; D015995:Prevalence; D013666:Tears; D014937:Work; D055815:Young Adult
keywords: OPHTHALMOLOGY; PREVENTIVE MEDICINE; PUBLIC HEALTH