Estimated Prevalence and Incidence of Dry Eye Disease Based on Coding Analysis of a Large, All-age United States Health Care System

• Published in: American journal of ophthalmology Vol. 202; pp. 47 - 54
• Main Authors: Dana, Reza, Bradley, John L., Guerin, Annie, Pivneva, Irina, Stillman, Ipek Özer, Evans, Amber M., Schaumberg, Debra A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2019; Elsevier Limited
• Subjects: Adolescent; Adult; Age; Age Distribution; Beneficiaries; Census of Population; Child; Child, Preschool; Codes; Computerized physician order entry; Cornea; Delivery of Health Care - statistics & numerical data; Demography; Diagnostic Techniques, Ophthalmological; Dry Eye Syndromes - classification; Dry Eye Syndromes - diagnosis; Dry Eye Syndromes - epidemiology; Economic indicators; Estimates; Eye diseases; Female; Follow-Up Studies; Health Surveys; Humans; Incidence; Lupus; Male; Middle Aged; Military service; Ophthalmology; Prevalence; Retrospective Studies; Sex Distribution; United States - epidemiology; Young Adult; United States; United States > US; Virginia
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2019.01.026

To assess overall prevalence, annual prevalence, and incidence of dry eye disease (DED) in a large, representative population in the United States.
Prevalence and incidence study.
Retrospective analysis using the Department of Defense (DOD) Military Health System (MHS) data on beneficiary medical claims from United States DOD military and civilian facilities, January 1, 2003 through March 31, 2015. Patient Population: Using an algorithm, medical diagnostic codes indicative of DED and prescriptions for cyclosporine ophthalmic emulsion identified a DED population from 9.7 million MHS beneficiaries (DOD service members, retirees, and dependents, aged 2-80+ years). Main Outcome Measures: DED overall prevalence (2003-2015), annual prevalence (2005-2012), and annual incidence (2008-2012) stratified by sex, age group, and International Statistical Classification of Diseases and Related Health Problems, Ninth Revision diagnosis code grouping.
DED prevalence was 5.28% overall, 7.78% among female beneficiaries, 2.96% among male beneficiaries and increased with age from 0.20% for ages 2-17 years, to 11.66% for individuals aged 50+ years. Annual prevalence increased from 0.8% to 3.0% overall, from 1.4% to 4.5% in female beneficiaries, and from 0.3% to 1.6% in male beneficiaries. Annual prevalence increased across age groups starting at age 18-39, 0.1%-0.6%, to age 50+, 1.8%-6.0%. Annual incidence increased from 0.6% to 0.9% overall, from 0.8% to 1.2% in female beneficiaries, and from 0.3% to 0.6% in male beneficiaries. Across age groups, annual incidence increased starting at age 18-39 (0.2%-0.3%), to age 50+ (1.0%-1.6%).
DED overall prevalence, annual prevalence, and incidence were found to increase over time for all demographics. These findings highlight the continued importance of research and therapeutic development for this common condition.
•This study captures a uniquely broad view of the epidemiology of dry eye disease across all ages.•This study provides the first evidence of an increase in incidence/prevalence over time.•This study provides the first evidence of an increase in incidence starting in young adulthood.