Prevalence and Behavioral-Based Risk Factors (Eye Cosmetic and Tobacco Use) of Symptomatic Dry Eye Disease in Four Middle Eastern Countries: Lebanon, Syria, Jordan, and Palestine

Abstract

To estimate the prevalence of symptomatic dry eye disease (DED) in four Middle Eastern Countries and investigate the association between behavioral-based risk factors and severity of DED. Patients and Methods: Population-based cross-sectional study of 1463 participants from 4 Mediterranean countries (Lebanon, Syria, Jordan, and Palestine). The Arabic version of the Ocular Surface Disease Index (ARB-OSDI) questionnaire was used to estimate the prevalence and severity of symptomatic DED using an online format survey. The survey also included demographic questions and possible behavioral risk factors (tobacco and cosmetic use). One-Way ANOVA and multivariate regression analyses were used to investigate the association between OSDI mean scores and behavioral-based risk factors. Results:The prevalence of symptomatic DED (OSDI score ≥ 13) among the overall population (332 males and 1132 females) reached 70.2%. Tobacco and cosmetic users reported a higher significant prevalence and severity of symptomatic DED than non-users (p < 0.0001). Smoking habits (eg, smoking cigarettes or Ajami, smoking in closed areas, and daily smoking) were more likely to report symptomatic DED. Bad hygiene process during the use of any cosmetic product was behind the high prevalence and severity of symptomatic DED among the females of the study population. Conclusion: Symptomatic DED is substantial in Middle Eastern countries. It is statistically associated with cosmetic and tobacco use.

Dry Eye Disease in the Middle East and Northern Africa: A Position Paper on the Current State and Unmet Needs

“…26 Prevalences for countries having only a single estimate indicated DED values of 69% for Palestine (West Bank), 52% for Jordan, 27.2% for Iraq, 10% for United Arab Emirates, 28.5% for Tunisia, 36.4% for Lebanon, and 40% for Libya. 26 Additional sources have indicated a DED prevalence of 15% for Israel, 27 65.2% for Syria, 28 and 52.8% for Turkey. 29 Taken together, the varied outcomes reported in the above-mentioned studies indicate that the overall prevalence of DED in MENA is not clearly established.…”

“…The OSDI is a useful tool for assessing the severity of DED. Patients are considered positive for DED if their total OSDI score is ≥13, with further subdivisions into Clinical Ophthalmology 2024:18 https://doi.org/10.2147/OPTH.S436027 DovePress 683 mild (score [13][14][15][16][17][18][19][20][21][22], moderate (score [23][24][25][26][27][28][29][30][31][32], and severe (score . The panel also suggested that a visual analogue scale of DED symptoms may provide a quick and reliable assessment of disease severity and patient burden.…”