Evidence of seasonality and effects of psychrometry in dry eye disease

Abstract

ABSTRACT.Purpose: Current models consider the development of dry eye disease (DED) as a more or less continuous process with only minor daily variations. Clinical evidence, however, does suggest the existence of phase-like recurring dry eye complaints that may be linked to seasonal environmental conditions. In this survey-based study, we examined the influence of seasonality in dry eye pathophysiology. Methods: A specific protocol for a telephone interview was created. Then, 738 patients suffering from dry eye and/or Sj€ ogren's syndrome were interviewed and asked about the impact of the four seasons and other weather conditions on their ocular symptoms. Data were statistically analysed. All data were compared in respect to the relation between season, gender, country of origin and the presence of comorbidities. Results: Overall, 47% of respondents stated that seasonal conditions had a high impact on their DED symptoms, with only 15% reporting that there was no seasonal impact on their symptoms. Wind was the most commonly reported weather condition to impact dry eye symptoms (for 71% of patients), followed by sunshine (60%) and heat (42%). Cold weather was also reported to aggravate dry eye sensation by 34% of patients. The two seasons most commonly associated with dry eye complaints were summer and winter (for 51% and 43% of patients, respectively). Only 8% stated that no weather conditions affected their symptoms. Discussion: This study confirms the seasonal enhancement of dry eye sensations and symptoms. Environmental characteristics such as cold and heat as well as wind were the most commonly cited triggering factors. Geographical differences do exist between the countries surveyed and the seasonal peak of complaints appears related to temperature and humidity. The main seasons of dry eye complaints in Europe were winter and summer. Such seasonal characteristics in ocular surface disease should be kept in mind when considering diagnosis and treatment as well when investigating the ocular surface. Conclusion: Our study confirmed high prevalence of both seasonal and weatherrelated enhancement of dry eye sensations and symptoms.

Patients' perception of DED and its relation with time to diagnosis and quality of life: an international and multilingual survey

“…Because the survey was conducted in five European countries, the subjective responses would have been influenced by cultural and linguistic subtleties, and these differences provided helpful and relevant information to build more effective language-specific diagnostic tools. Furthermore, some intercountry variations in symptoms description and QoL impact may be explained by differences in climate and environmental factors, as discussed elsewhere 24. Similarly, different healthcare, insurance and DED management systems across countries would have also influenced disease perception (ie, ‘disease’ vs ‘handicap’, as the latter is associated with increased reimbursement in some countries).…”

Clinical impact of inflammation in dry eye disease: proceedings of the ODISSEY group meeting

“…Furthermore, dry eye sensations and symptoms were recently confirmed to be enhanced by seasonal conditions (van Setten et al. ).…”

Dry eye disease and oxidative stress

“…Environmental conditions such as the windy and cold temperatures have been known to vary with seasons and aggravate dry eye signs and symptoms (van Setten et al. ). These epidemiological studies will have clinical implications as preventive strategies could be employed in those occupationally at risk.…”

“…Studies are required to evaluate the role of environmental triggers of oxidative stress, for example pollutants, sunlight and smoking on their contribution to dry eye. Environmental conditions such as the windy and cold temperatures have been known to vary with seasons and aggravate dry eye signs and symptoms (van Setten et al 2016). These epidemiological studies will have clinical implications as preventive strategies could be employed in those occupationally at risk.…”