Introduction: Dry Eye is a multifactorial disease of the tearfilm and the ocular surface which may be due to reduced tear production or excessive tear evaporation resulting in discomfort, visual disturbance, and tear film instability with a potential damage to the ocular surface. Various population-based studies have been done to find out the prevalence and the magnitude of the problem. Women Health Study reported prevalence of 7.8% after screening 36995 subjects above 49 years by interview. The prevalence reported by Blue Mountain Study was 15.3% .The Beaver Dam Study and Shiphai Eye studies are other studies reporting prevalence of 14.5% and 33.7% respectively. McMonnies questionnaire is a widely used screening instrument for Dry-Eye syndromes with sensitivity reportedly varying between 87% and 98% and specificity between 87% and 97%. Prevalence studies use McMonnie?s questionnaire for screening individuals for Dry Eye, whereafter tests like Schirmer?s test, Tear Film Break Up Time test, Rose Bengal test, Lissamine Green test and Meibomian Gland Dysfunction test are useful for further evaluation. While these tests help to differentiate the subtypes of Dry Eye such as Lipid Anomaly Dry Eye, Aqueous Tear Deficiency and Mucin Layer Deficiency, however, their sensitivity and specificity has not been widely studied. Additionally, very few studies have reported the prevalence of the various subtypes of Dry Eye.Aim and Objectives: To determine the subtype-based prevalence of Dry Eye, to study the specificity and sensitivity of clinical tests for Dry Eye and to correlate McMonnies questionnaire with Dry Eye tests results.Material and Methods: A prospective, cross-sectional, observational study, duly approved by the Institutional Ethics Committee, was conducted from October 2010 to April 2012. A total of 4750 subjects above 18 yrs of age were screened by the McMonnies questionnaire. Respondents having a score greater than 14.5 were subjected to clinical Dry Eye tests. The data obtained was analyzed using chi-square test. P value < 0.005 was considered statistically significant.The specificity and sensitivity of each clinical test was calculated using Schirmer?s test as gold standard.Results: The prevalence of Dry Eye was 15.4%, with a female preponderance (p = 0.01) and a significant increase with age above 60 years was noted (p<0.0001). Tear Film Break Up Time was the most reliable test with a good sensitivity (68.85%) and specificity (78.32%). Lipid Anomaly Dry Eye was the most prevalent (14.48%) followed by Aqueous Tear Deficiency (13.36%) and Mucin Layer Deficiency (3.51%). A positive correlation between McMonnies score and severity of Dry Eye was seen.Conclusion: This study suggests that Lipid Layer Anomaly is the most prevalent subtype in Dry Eye. Tear Film Break Up Time test is the most likely test to diagnose mild Dry Eye. McMonies Questionnaire can be effectively used for screening of a large population. Tear Film Break Up Time was found to have better sensitivity as well as specificity than other tests used for diagnosing Dry Eye.
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机译：简介：干眼症是泪膜和眼表的多因素疾病，可能是由于减少的泪液产生或过度的泪液蒸发导致不适，视觉障碍和泪膜不稳定，并对眼表造成潜在损害。已经进行了各种基于人口的研究，以找出问题的普遍性和严重性。 《妇女健康研究》报告说，在通过访谈筛查49995岁以上的36995名受试者后，患病率为7.8％。 Blue Mountain研究报告的患病率为15.3％，Beaver大坝研究和Shiphai Eye研究为其他报告的患病率，分别为14.5％和33.7％。 McMonnies问卷是一种广泛使用的干眼症筛查工具，据报道其敏感性在87％至98％之间，特异性在87％至97％之间。患病率研究使用McMonnie的问卷对个人进行干眼筛查，之后进行Schirmer检验，Tear Film Breaking Time检验，Rose Bengal检验，Lissamine Green检验和Meibomian腺功能障碍检验等检验对进一步评估很有用。尽管这些测试有助于区分干眼症的亚型，如脂质异常干眼症，眼泪水缺乏症和粘蛋白层缺乏症，但是，它们的敏感性和特异性尚未得到广泛研究。此外，很少有研究报道干眼症的各种亚型的患病率。目的：确定干眼症的亚型患病率，研究干眼症临床试验的特异性和敏感性，并将McMonnies问卷与干眼测试结果。材料与方法：从2010年10月至2012年4月，进行了一项由机构伦理委员会正式批准的前瞻性，横断面，观察性研究。该研究筛选了4750名18岁以上的受试者。 McMonnies问卷。得分大于14.5的受访者接受了临床干眼测试。使用卡方检验分析获得的数据。 P值<0.005被认为具有统计学意义。以Schirmer's检验为金标准，计算每个临床试验的特异性和敏感性。结果：干眼症患病率为15.4％，女性占优势（p = 0.01）。并且注意到随着年龄超过60岁而显着增加（p <0.0001）。泪膜破裂时间是最可靠的测试，灵敏度高（68.85％），特异性高（78.32％）。脂质异常干眼是最普遍的（14.48％），其次是眼泪缺乏症（13.36％）和粘蛋白层缺乏症（3.51％）。结论：脂质层异常是干眼症中最普遍的亚型。结论：McMonnies评分与干眼症的严重程度呈正相关。泪膜破裂时间测试是诊断轻度干眼症的最可能测试。 McMonies问卷可以有效地用于筛查大量人口。发现泪膜破裂时间比用于诊断干眼症的其他测试具有更好的灵敏度和特异性。
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