title: Symptomatic Dry Eye and Its Associated Factors: A Study of University Undergraduate Students in Ghana.
abstract: BACKGROUND
  To estimate the prevalence and risk factors of symptomatic dry eye disease (DED) among undergraduate students in a Ghanaian university.
  
  
  METHODS
  This cross-sectional study included 700 undergraduate students of the University of Cape Coast, aged 18 to 34 years. Participants completed questionnaires delivered directly to randomly and systematically selected subjects to detect symptomatic dry eye and its predictive factors. Symptomatic dry eye was defined as any reported symptom on the Standard Patient Evaluation Eye Dryness (SPEED) questionnaire reported as often or constant or if any symptom on the Ocular Surface Disease Index (OSDI) was reported as most of the time or all of the time. Furthermore, OSDI ≥13 and SPEED ≥6 were used to defined symptomatic dry eye and prevalence were also estimated with these criteria as secondary measures. Current symptoms of dry eye and possible risk factors such as age, gender, current alcohol drinking, use of oral contraceptives, use of computer more than an hour daily, environmental conditions, allergies, and self-medication with over-the-counter eye drops were the main outcome measures. We used logistic regression analysis to examine the associations between dry eye and its predictive factors.
  
  
  RESULTS
  Of the 700 participants, 650 completed the questionnaire. The prevalence of symptomatic dry eye was 44.3% (95% confidence interval [CI], 40.6%-48.2%). There was a significant association between symptomatic dry eye and discomfort with eyes in windy conditions (χ=110.1; df=4; P<0.001), areas with low humidity (χ=91.6; df=4; P<0.001), and air-conditioned rooms (χ=89.0; df=4; P<0.001). Self-medication with over-the-counter eye drops (OR 4.20; 95% CI, 2.61-6.74; P<0.001), any allergies (OR 2.46; 95% CI, 1.42-4.29; P=0.001), and use of oral contraceptives (OR 4.04; 95% CI, 1.02-16.01; P=0.047) were predictive factors of symptomatic dry eye. Sex was predictive in univariate analysis but was not significantly associated in multivariate analysis.
  
  
  CONCLUSIONS
  The prevalence of symptomatic dry eye among undergraduate students in Ghana is high and it is associated with self-medication with over-the-counter eye drops, allergies, use of oral contraceptive, windy conditions, very low humid areas, air-conditioned rooms, and sex. Relevant input directed against modifiable risks factors may have a positive impact on the well-being of undergraduate students in Ghana.
authors.affiliation: Department of Optometry (K.A., S.K., F.B., S.O.), School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana; Eye Center (K.A.), Komfo Anokye Teaching Hospital, Kumasi, Ghana; and Department of Vision and Hearing Sciences (S.O.), Faculty of Science and Technology, Anglia Ruskin University, Cambridge, United Kingdom.
authors.forename: Kofi
authors.initials: K
authors.lastname: Asiedu
authors.forename: Samuel
authors.initials: S
authors.lastname: Kyei
authors.forename: Frank
authors.initials: F
authors.lastname: Boampong
authors.forename: Stephen
authors.initials: S
authors.lastname: Ocansey
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D003430:Cross-Sectional Studies; D015352:Dry Eye Syndromes / Q000453:epidemiology*; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D013334:Students / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014495:Universities; D055815:Young Adult