“…For the prevalence of DED by symptoms and signs, female sex was also found to be a positive covariate. The persisted sex difference across all ages has also been reported in some previous studies, which might be a combined result of different hormonal effects on the ocular surface, lacrimal gland, etc., however, this variation between sexes has not become a universally acknowledged notion in previous studies [12,15,44,45], this may be caused by different definitions of DED in their investigations, in our study, no sex difference was observed for the prevalence of DED by symptoms. More studies are still needed to explore if DED is a more prevalent condition among females, with a focus on different types of DED.…”