Modifiable lifestyle risk factors for dry eye disease

Michael T.M. Wang, Alex Muntz, Brinda Mamidi, James S. Wolffsohn, Jennifer P. Craig

Research output: Contribution to journalArticlepeer-review


Purpose: To examine the association between modifiable lifestyle factors and dry eye disease. Methods: Three hundred and twenty-two community residents (186 females, 136 males; mean ± SD age, 41 ± 22 years) with no major systemic or ophthalmic conditions (other than dry eye disease) were recruited in a cross-sectional study. A lifestyle factor questionnaire was administered, and dry eye symptomology, ocular surface characteristics, and tear film quality were evaluated for each participant within a single clinical session, in accordance with the global consensus recommendations of the TFOS DEWS II reports. Results: A total of 111 (34 %) participants fulfilled the TFOS DEWS II diagnostic criteria for dry eye disease. Multivariate regression analysis demonstrated that advancing age, female sex, East Asian ethnicity, and increased digital screen exposure time were positive risk factors for dry eye disease (all p < 0.05), while increased caffeine consumption was a protective factor (p = 0.04). Conclusions: Increased digital screen exposure time and reduced caffeine consumption were modifiable lifestyle factors associated with higher odds of dry eye disease. These findings might contribute to informing the design of future prospective research investigating the efficacy of preventative intervention and risk factor modification strategies.

Original languageEnglish
Article number101409
JournalContact Lens and Anterior Eye
Issue number6
Early online date20 Jan 2021
Publication statusPublished - 1 Dec 2021

Bibliographical note

© 2021, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International


  • Dry eye
  • Epidemiology
  • Lifestyle
  • Ocular surface
  • Risk factor
  • Tear film


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