Awareness and Knowledge Toward Dry Eye Disease Among Saudi

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Awareness and Knowledge Toward Dry Eye Disease Among Saudi Allam Khalid et al, 2021;5(3):838–844. International Journal of Medicine in Developing Countries https://doi.org/10.24911/IJMDC.51-1609345198 ORIGINAL ARTICLE Awareness and knowledge toward dry eye disease among Saudi Arabian population Allam Khalid1, Aladhyani Abdulwahab2, Alharbi Aseel3, Alshngeetee Ayshah4*, Alharbi Khalid5, Aljuaid Mohammed6, Alshowigi Njood4, Alghamdi Omar7, Alnuman Rawand8, Alkhaldi Saleh9 ABSTRACT Background: Dry eye syndrome (DES), also known as keratoconjunctivitis sicca (KCS), affects the tear film either by decreasing the production of tears or by increasing the evaporation of tears. Also, the syndrome is multifactorial, where patients usually complain of a variety of symptoms, including dry eyes, burning sensa- tion, pain, and photophobia. The present study aimed at measuring the awareness and knowledge regarding DES among the population of Saudi Arabia via a questionnaire. Methodology: Healthy Saudi adults (male and female) would answer an online questionnaire delivered by social media to measure the awareness of KCS among patients aged from 18 to 55 years, where healthcare providers were not allowed to participate in the study. Results: In this study, we received 451 responses to our questionnaire. Almost half of the participants were aged between 18 and 25 years, while 28.6% were aged between 36 and 55 years. Females represented a slightly higher percentage of the sample (57.9%). Asthma was the most commonly reported chronic condition with a prevalence of 9.1%, while hypertension prevalence was 6.2%. Moreover, most of the participants indi- cated that they had not had any ocular surgery (82%), while 11.8% indicated that they had refractive surgery and 5.1% had other surgery. Conclusion: We had observed a poor attitude toward DES among the Saudi Arabian population, including that most of the participants did not have a routine ophthalmologist visit and tended to use electronic devices for a long time without a break knowing about their risk Keyword: Dry eye, DES, complication, knowledge, treatment, causes. Introduction Dry eye syndrome (DES) known as keratoconjunctivitis prevalence of DES varies between different regions and sicca is a condition that affects the tear film either by time; however, it ranges between 9.5% and 90% [6-8]. decreasing the production of tears or by increasing This difference may be because DES is affected by the the evaporation of tears. Also, the syndrome is populations’ geographic location and characteristics multifactorial, and it may occur due to either aqueous besides the variation in the diagnostic criteria used in tear deficiency or meibomian gland dysfunction, and those studies. However, similarly, the prevalence of DES the syndrome may occur due to both [1,2]. Moreover, is higher in Asian countries than in Western countries [9]. the patient complains of various symptoms, including On the other hand, the prevalence of DES among other dry eyes, burning sensation, pain, and photophobia [1]. The signs have a different course; it may come as a mild transient to persistent irritation [2]. Moreover, dry Correspondence to: Alshngeetee Ayshah eye disease is a common ocular surface disorder that *Imam Mohammed Ibn Saud Islamic University, Riyadh, has a significant impact on the patients’ vision-related Saudi Arabia. quality of life. Therefore, it is considered a public health Email: [email protected] problem [3,4]. Female gender, age more than 56, current Full list of author information is available at the end of the article. smoking, and history of diabetes mellitus are some of Received: 30 December 2020 | Accepted: 19 January 2021 the significant risk factor of DES [5]. Furthermore, the © IJMDC. https://www.ijmdc.com 838 Awareness and knowledge toward dry eye disease cities in Saudi Arabia showed that it was 45.1% among while hypertension prevalence was 6.2%, thyroid gland the Riyadh governorate population (except the capital) disease had a prevalence of 5.8%, and 5.5% reported [10]. Furthermore, 32.1% of the Al-Ahsa population having a high cholesterol level. However, 67% of the showed symptomatic DES [5]. participants indicated having no medical conditions Moreover, we observed that the number of patients who (Figure 1). visited the ophthalmology clinic with complaints of DES 73.4% of the participants did not take any medications, was going up, so we aimed to measure the awareness while painkillers were the most common medications and knowledge regarding DES among the Saudi Arabia taken by participants (11.5%), followed by other population to evaluate the level of health education medicines (11.1%) and hypertensive medications (5.8%) regarding DES. (Figure 2). Subjects and Methods Moreover, most participants indicated that they had not had any ocular surgery (82%), while 11.8% indicated This study is a cross-sectional study based on a having refractive surgery and 5.1% had other surgeries community-based, self-administer questionnaire that (Figure 3). assessed the knowledge and awareness of dry eye among Attitude toward dry eye: Most participants reported that the general population in Saudi Arabia via an online they used spectacles (42.8%) and 38.1% of them indicated questionnaire. A pilot study was conducted to validate that artificial tears and sunglasses were used by 31% of the questionnaire which was distributed through social the participants. However, 24.4% of the participants media in Saudi Arabia. The sample size was calculated stated that they did not use any of the options. Moreover, using the formula n = z2pq\d2. With a confidence level of using electronic devices for a long time without a break 95%, an estimated proportion of 50%, and a 5% level of and eye rub were the most common habits related to the precision, the minimum sample size was calculated to be samples’ eye (66.1% and 59.0%, respectively). Other 385. Inclusion criteria included all adults, healthy adults habits include eye makeup (21.1%), smoking (16.2%), aged 18 years and above of both genders. Those who and exposure of the eyes to air (14.2%). Furthermore, were below 18 years of and who worked as healthcare most of the sample indicated that they did not have a providers were excluded. An online, self-administered routine ophthalmologist visit (88.9%) (Table 2). questionnaire was distributed through social media. The questionnaire included five sections; the first section is Knowledge toward DES: More than half of the sample a consent form to join the research; the second section indicated that they had known about DES (53.7%), while is related to demographic data; the third section contains questions of past medical and medication history. The fourth section includes questions about caring for eyes, Table 1. Demographic factors. and the fifth section questions assessing the awareness and knowledge regarding DES. Data analysis was Frequency Percent conducted using Statistical Package for the Social Age 18-25 209 46.3 Sciences version 23. Frequency and percentages were 26-35 84 18.6 used to display categorical variables. A chi-squared test was used to test for the presence of an association 36-55 129 28.6 between categorical variables. Independent t-test and Over 55 29 6.4 analysis of variance test were utilized to test for the Gender Male 190 42.1 association within continuous variables. The level of Female 261 57.9 significance was set at p < 0.05. Occupation Housewife 99 22.0 Results Health sector 110 24.4 Education sector 127 28.2 Demographic factors: In this study, we received 451 Engineering 23 5.1 responses to our questionnaire. Almost half of the participants were aged between 18 and 25 years, while Economy and business 63 14.0 administration 28.6% were aged between 36 and 55 years. Females represented a slightly higher percentage of the sample Security and military 15 3.3 (57.9%). Considering the participants’ occupations, Science and research 7 1.6 most of the participants (28.2%) were in the education arts 7 1.6 sector, 24.4% were in the health sector, and 22% were Province Central 170 37.7 housewives. Moreover, most of the sample was from the western and central regions (45% and 37.7%, Western 203 45.0 respectively) (Table 1). Southern 18 4.0 Eastern 17 3.8 Chronic conditions: Asthma was the most commonly reported chronic condition with a prevalence of 9.1%, Northern 43 9.5 839 Awareness and knowledge toward dry eye disease Figure 1. Chronic conditions. Figure 2. Medications taken by participants. Figure 3. Medical history of ocular surgery. 70.1% of them thought that DES is widely spread in causes of DES. Considering symptoms of DES, stinging Saudi Arabia (Table 3). and burning sensations were the most known symptoms Moreover, the most known causes of DES by participants reported by the participants (55.7% for each), followed were prolonged use of electronic devices (71.6%), by foreign body sensation (48.1%), redness (46.8%), and weather conditions (56.5%), lacrimal gland disorder eye strain (43.2%). In comparison, 18.4% did not know (31.7%), thyroid gland disorder (31.5%), rheumatoid about the symptoms. Furthermore, 38.8% of the sample arthritis (31.5%), and refractive surgery (30.2%), while indicated that blurred vision could be a complication of 16.6% of participants reported that they did not know the DES, followed by corneal abrasion (35.3%) and 32.8% 840 Awareness and knowledge toward dry eye disease Table 2. Attitude toward dry eye. Frequency Percent Do you use any of these? No medications 110 24.4 Spectacles 193 42.8 Sunglasses 140 31.0 Contact lens 71 15.7 Artificial tears 172 38.1 Eye ointments 17 3.8 Do you do any of the Eye rub 266 59.0 following? Use electronic devices for a 298 66.1 long time without a break Eye makeup 95 21.1 Smoking 73 16.2 Expose eyes directly to air 64 14.2 None 52 11.5 Routine ophthalmologist Yes 50 11.1 visit No 401 88.9 Table 3.
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