Brittanica defines quality of life (QOL) as “the degree to which an individual is healthy, comfortable, and able to participate in or enjoy life events.” (www.britannica.com/topic/quality-of-life ) Research has indicated that many illnesses have the potential to impact an individual’s QOL (Guo and Akpek, 2020). “Quality of life” can refer to an individual’s experience or to the environment in which an individual lives. There is abundant evidence that dry eye, one of the most prevalent of conditions encountered in clinical eyecare practice, can negatively impact QOL (Paulsen et al, 2014).

The signs and symptoms of dry eye are well known and can differ significantly from one individual to another. These symptoms may include, but are not limited to, a gritty sensation, burning, excessive tearing, and photophobia (Paulsen et al, 2014). Because dry eye frequently leads to an unstable refractive surface, individuals often experience blurring and other alterations of vision (Paulsen et al, 2014).

Paulsen et al (2014) utilized data extracted from the Beaver Dam Offspring Study (BOSS) to determine the prevalence of dry eye, evaluate for risk factors associated with dry eye, and quantify the impact of dry eye on health-related QOL. They found 3,275 individuals who met the necessary criteria for inclusion in their study. Using logistic regression, they analyzed the association between dry eye and risk factors, and they determined that the overall prevalence of dry eye in BOSS was 14.5% (17.9% in females and 10.5% in males) (Paulsen et al, 2014).

Evaluating Quality of Life

QOL was evaluated using The Medical Outcomes Short-Form 36 (SF-36) and the National Eye Institute-Visual Functioning Questionnaire (NEI-VFQ 25). Individuals who reported dry eye symptoms were 64% more likely to report symptoms associated with depression (Paulsen et al, 2014). Dry eye symptoms were associated with notably lower health-related QOL scores as measured by the SF-36 and the NEI-VFQ. This study by Paulsen and colleagues (2014) demonstrates a very strong association between DED and reduced QOL.

In a similar study conducted in Thailand, Tansanguan et al (2021) evaluated a Thai-translated version of the Dry Eye-Related Quality-of-Life Score (DEQS-Th). Their questionnaire was a 15-item self-report measuring dry eye and its impact on QOL. The DEQ-Th questionnaire was divided into two subscales: Bothersome Ocular Symptoms and Impact on Daily Life. The participants’ mean age was 38.6 ± 12.9 years, and 23 (76.7%) were females. All worked indoors. The mean score for Bothersome Ocular Symptoms was 0.65 and for Impact on Daily Life was 0.88 (Tansanguan et al, 2021).

Both of these studies confirm what is a common finding in the literature: dry eye disease impacts QOL. What is interesting about the sites for these studies is that they were conducted in geographically disparate locations—one in Madison, WI, which is located in the northernmost part of the United States, and the other in a tropical city below the equator. Madison, WI, has an average annual snowfall of 53 inches, while the average air temperature in Thailand in winter is 80.6ºF. Despite these differences, dry eye affects QOL in both regions.

These finding suggest that including some form of QOL questionnaire as part of a dry eye evaluation could be beneficial for both patients and providers. CLS

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