Association between symptoms and signs of dry eye among an elderly Chinese population in Taiwan

The Shihpai Eye Study

Pei Yu Lin, Ching Yu Cheng, Wen-Ming Hsu, Su Ying Tsai, Ming Wei Lin, Jorn Hon Liu, Pesus Chou

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

PURPOSE. To analyze the association between dry-eye symptoms and signs in an elderly Chinese population in Taipei, Taiwan. METHODS. The participants were those of the Shihpai Eye Study, a population-based survey of eye diseases in the elderly (≥65 years) in Shihpai, Taipei, Taiwan. Of 2045 randomly selected noninstitutionalized residents, 1361 (66.6%) participated in the study. Dry-eye symptoms were evaluated with an interviewer-administered questionnaire. Dry-eye signs, including tear-film breakup time, Schirmer test result, score for fluorescein staining of the cornea, and meibomian gland dysfunction, were assessed. Correlations between symptoms and signs were analyzed. RESULTS. Of the participants, 33.7% (459/1361) were symptomatic, defined as reporting one or more symptoms often or all the time. A Schirmer result of ≤5 mm was the only sign associated with frequent symptoms (P = 0.028). Its sensitivity and specificity in detecting symptomatic subjects were 62.5% and 43.7%, respectively. The agreement between each sign was statistically significant, although weak, except that no correlation was found between the Schirmer result and meibomian gland anomalies. Of the symptomatic subjects, 85.4% (392/459) had either a low Schirmer result or a meibomian gland anomaly; 38.8% (178/459) of them were abnormal on both tests. CONCLUSIONS. The Schirmer test was shown to be incapable of detecting meibomian gland disease. However, a low Schirmer result was significantly associated with dry-eye symptoms in this elderly Chinese population. This result differs from that of previous reports of elderly white populations. Further studies are needed to determine whether this difference indicates racial diversity in the distribution and behavior of dry-eye diseases.

Original languageEnglish
Pages (from-to)1593-1598
Number of pages6
JournalInvestigative Ophthalmology and Visual Science
Volume46
Issue number5
DOIs
Publication statusPublished - Dec 1 2005
Externally publishedYes

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Meibomian Glands
Taiwan
Signs and Symptoms
Eye Diseases
Population
Fluorescein
Tears
Cornea
Interviews
Staining and Labeling
Sensitivity and Specificity

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Association between symptoms and signs of dry eye among an elderly Chinese population in Taiwan : The Shihpai Eye Study. / Lin, Pei Yu; Cheng, Ching Yu; Hsu, Wen-Ming; Tsai, Su Ying; Lin, Ming Wei; Liu, Jorn Hon; Chou, Pesus.

In: Investigative Ophthalmology and Visual Science, Vol. 46, No. 5, 01.12.2005, p. 1593-1598.

Research output: Contribution to journalArticle

Lin, Pei Yu ; Cheng, Ching Yu ; Hsu, Wen-Ming ; Tsai, Su Ying ; Lin, Ming Wei ; Liu, Jorn Hon ; Chou, Pesus. / Association between symptoms and signs of dry eye among an elderly Chinese population in Taiwan : The Shihpai Eye Study. In: Investigative Ophthalmology and Visual Science. 2005 ; Vol. 46, No. 5. pp. 1593-1598.
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abstract = "PURPOSE. To analyze the association between dry-eye symptoms and signs in an elderly Chinese population in Taipei, Taiwan. METHODS. The participants were those of the Shihpai Eye Study, a population-based survey of eye diseases in the elderly (≥65 years) in Shihpai, Taipei, Taiwan. Of 2045 randomly selected noninstitutionalized residents, 1361 (66.6{\%}) participated in the study. Dry-eye symptoms were evaluated with an interviewer-administered questionnaire. Dry-eye signs, including tear-film breakup time, Schirmer test result, score for fluorescein staining of the cornea, and meibomian gland dysfunction, were assessed. Correlations between symptoms and signs were analyzed. RESULTS. Of the participants, 33.7{\%} (459/1361) were symptomatic, defined as reporting one or more symptoms often or all the time. A Schirmer result of ≤5 mm was the only sign associated with frequent symptoms (P = 0.028). Its sensitivity and specificity in detecting symptomatic subjects were 62.5{\%} and 43.7{\%}, respectively. The agreement between each sign was statistically significant, although weak, except that no correlation was found between the Schirmer result and meibomian gland anomalies. Of the symptomatic subjects, 85.4{\%} (392/459) had either a low Schirmer result or a meibomian gland anomaly; 38.8{\%} (178/459) of them were abnormal on both tests. CONCLUSIONS. The Schirmer test was shown to be incapable of detecting meibomian gland disease. However, a low Schirmer result was significantly associated with dry-eye symptoms in this elderly Chinese population. This result differs from that of previous reports of elderly white populations. Further studies are needed to determine whether this difference indicates racial diversity in the distribution and behavior of dry-eye diseases.",
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T1 - Association between symptoms and signs of dry eye among an elderly Chinese population in Taiwan

T2 - The Shihpai Eye Study

AU - Lin, Pei Yu

AU - Cheng, Ching Yu

AU - Hsu, Wen-Ming

AU - Tsai, Su Ying

AU - Lin, Ming Wei

AU - Liu, Jorn Hon

AU - Chou, Pesus

PY - 2005/12/1

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N2 - PURPOSE. To analyze the association between dry-eye symptoms and signs in an elderly Chinese population in Taipei, Taiwan. METHODS. The participants were those of the Shihpai Eye Study, a population-based survey of eye diseases in the elderly (≥65 years) in Shihpai, Taipei, Taiwan. Of 2045 randomly selected noninstitutionalized residents, 1361 (66.6%) participated in the study. Dry-eye symptoms were evaluated with an interviewer-administered questionnaire. Dry-eye signs, including tear-film breakup time, Schirmer test result, score for fluorescein staining of the cornea, and meibomian gland dysfunction, were assessed. Correlations between symptoms and signs were analyzed. RESULTS. Of the participants, 33.7% (459/1361) were symptomatic, defined as reporting one or more symptoms often or all the time. A Schirmer result of ≤5 mm was the only sign associated with frequent symptoms (P = 0.028). Its sensitivity and specificity in detecting symptomatic subjects were 62.5% and 43.7%, respectively. The agreement between each sign was statistically significant, although weak, except that no correlation was found between the Schirmer result and meibomian gland anomalies. Of the symptomatic subjects, 85.4% (392/459) had either a low Schirmer result or a meibomian gland anomaly; 38.8% (178/459) of them were abnormal on both tests. CONCLUSIONS. The Schirmer test was shown to be incapable of detecting meibomian gland disease. However, a low Schirmer result was significantly associated with dry-eye symptoms in this elderly Chinese population. This result differs from that of previous reports of elderly white populations. Further studies are needed to determine whether this difference indicates racial diversity in the distribution and behavior of dry-eye diseases.

AB - PURPOSE. To analyze the association between dry-eye symptoms and signs in an elderly Chinese population in Taipei, Taiwan. METHODS. The participants were those of the Shihpai Eye Study, a population-based survey of eye diseases in the elderly (≥65 years) in Shihpai, Taipei, Taiwan. Of 2045 randomly selected noninstitutionalized residents, 1361 (66.6%) participated in the study. Dry-eye symptoms were evaluated with an interviewer-administered questionnaire. Dry-eye signs, including tear-film breakup time, Schirmer test result, score for fluorescein staining of the cornea, and meibomian gland dysfunction, were assessed. Correlations between symptoms and signs were analyzed. RESULTS. Of the participants, 33.7% (459/1361) were symptomatic, defined as reporting one or more symptoms often or all the time. A Schirmer result of ≤5 mm was the only sign associated with frequent symptoms (P = 0.028). Its sensitivity and specificity in detecting symptomatic subjects were 62.5% and 43.7%, respectively. The agreement between each sign was statistically significant, although weak, except that no correlation was found between the Schirmer result and meibomian gland anomalies. Of the symptomatic subjects, 85.4% (392/459) had either a low Schirmer result or a meibomian gland anomaly; 38.8% (178/459) of them were abnormal on both tests. CONCLUSIONS. The Schirmer test was shown to be incapable of detecting meibomian gland disease. However, a low Schirmer result was significantly associated with dry-eye symptoms in this elderly Chinese population. This result differs from that of previous reports of elderly white populations. Further studies are needed to determine whether this difference indicates racial diversity in the distribution and behavior of dry-eye diseases.

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