Clinical subtypes of dry eye in youthful clinical sample in Ghana.

Purpose: To evaluate in a cohort of patients with dry eye disease (DED) the distribution of patients with asymptomatic and symptomatic dry eye involving aqueous deficient or the evaporative subtype of DED.

Methods: This was a clinic-based cross-sectional study of consecutive patients visiting the University of Cape Coast eye clinic for a comprehensive eye examination. Eligible participants completed the Ocular Surface Disease Index (OSDI), ocular surface staining and tear break up time. Subjects with dry eye (symptomatic or asymptomatic) underwent clinical examination comprising lid margin assessments, meibomian gland expressibility and quality assessments, and Schirmer 1 test.

Results: A total of 172 patients were included in the study. The mean age of the eligible participants was 22.7 (±3.7) years, with a range of 17-35 years. There were 83 males and 89 females in the sample. There was an association between the form of the dry eye whether symptomatic or asymptomatic and sex, (X = 6.51 df = 1 p = 0.011). The frequency of symptomatic aqueous-deficient dry eye was 9(5.2%) whiles that of the symptomatic evaporative dry eye was 20(11.6%). The frequencies of the asymptomatic aqueous-deficient dry eye and asymptomatic evaporative dry eye were 9(5.2%) and 12(7.0%) respectively. The frequency of symptomatic mixed dry eye was 30(17.4%) and the asymptomatic mixed dry eye was 8(4.7%). The distribution of unclassifiable dry eye among the symptomatic dry eye group was 41(23.8%) and 43(25%) among the asymptomatic dry eye group.

Conclusion: The number of patients exhibiting signs of the evaporative dry eye resulting from meibomian gland dysfunction far outnumbers those of aqueous deficient dry eye but there remains a high unclassifiable group with an unknown etiology. Further, studies are needed to explore the other etiology or etiologies of dry eye apart from meibomian gland dysfunction and reduced aqueous production.