A Comprehensive Review of Sex Disparities in Symptoms, Pathophysiology, and Epidemiology of Dry Eye Syndrome.
BACKGROUND
The etiology, frequency, manifestation, and treatment of dry eye syndrome are commonly influenced by sex and gender.


METHODS
This study aims to review the differences in epidemiology, pathophysiology, and associated diseases between the sexes. The terms men and male and women and female are used interchangeably throughout the review to refer to biological sex.


RESULTS
There are numerous objective and subjective markers of dry eye syndrome but not one diagnostic criterion. There are numerous associated conditions with dry eye syndrome varying from autoimmune to allergic. Large epidemiologic studies reviewed suggest that there does indeed exist a difference between dry eye symptoms between men and women, with women having dry eye signs and reporting dry eye symptoms more often than men. The increased prevalence in women could be correlated to an increased association with certain systemic diseases, specifically autoimmune diseases, and to hormonal variations. Several studies found equivocal data about prevalence of dry eye symptoms between men and women.


CONCLUSIONS
Interpreting studies that investigate epidemiology, pathogenesis, and treatment of dry-eye conditions is complicated by the lack of universally adapted diagnostic criteria and standardized, specific diagnostic tests, and inter-study variability in the definition of dry eye syndrome.
a Department of Ophthalmology , Massachusetts Eye and Ear, Harvard Medical School , Boston , MA , USA.
Yuna
Y
Rapoport
b Vanderbilt University Medical School , Nashville , TN , USA.
Jason M
JM
Singer
c Department of Ophthalmology and Visual Sciences , Vanderbilt University Medical Center , Nashville , TN , USA.
Jeanie D
JD
Ling
d Department of Ophthalmology , Emory University , Atlanta , GA , USA.
Anthony
A
Gregory
c Department of Ophthalmology and Visual Sciences , Vanderbilt University Medical Center , Nashville , TN , USA.
Sahar
S
Kohanim
D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D015995:Prevalence; D012737:Sex Factors
Disparities; dry eye; gender; hormones; keratoneuralgia; sex