PURPOSE To investigate the prevalence of dry eye among all adult age categories and to discover independent risk factors by investigating a wide range of etiological categories. METHODS A cross-sectional association study including 79,866 voluntary participants aged 20-94 years of the population-based Lifelines Cohort Study in the Netherlands. RESULTS Overall, 9.1% of participants had dry eye disease as measured by the Women's Health Study dry eye questionnaire. Prevalence of dry eye symptoms were particularly prevalent in 20-30 years old. Dry eye was associated with comorbidities in almost all body systems, including musculoskeletal, gastro-intestinal, ophthalmic, autoimmune, psychiatric, pain, functional, dermatological and atopic disorders. Numerous independent risk factors were discovered or confirmed, with strong associations for female sex, contact lens use, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, eye surgery including cataract and laser refractive surgery, keratoconus, osteoarthritis, connective tissue diseases, atherosclerosis, Graves' disease, autistic disorder, depression, 'burnout', Crohn's disease, sarcoid, lichen planus, rosacea, liver cirrhosis, sleep apnea, sinusitis, thyroid function, and air pollution (NO2). High blood pressure and high BMI were strongly associated with less dry eye, as was current smoking, while ex-smokers had more dry eye. No clear link between dry eye and lipid or blood glucose levels was found. CONCLUSIONS This study on dry eye confirmed but also refuted many risk factors from smaller epidemiological studies, and discovered numerous new risk factors in multiple etiological categories. The finding that dry eye symptoms are particularly common in young adults is concerning, and warrants further study.

中文翻译：

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在荷兰进行的以人口为基础的生命线队列研究的79,866名参与者中，干眼症的患病率和危险因素。

目的调查所有成人年龄类别中干眼症的患病率，并通过调查广泛的病因类别来发现独立的危险因素。方法一项横断面协会研究包括荷兰基于人群的生命线队列研究的79,866名年龄在20-94岁之间的自愿参与者。结果总体而言，根据妇女健康研究干眼问卷调查，有9.1％的参与者患有干眼症。干眼症状的流行在20-30岁特别普遍。干眼症与几乎所有身体系统的合并症相关，包括肌肉骨骼，胃肠道，眼科，自身免疫性，精神病，疼痛，功能性，皮肤病学和特应性疾病。发现或确认了许多独立的危险因素，与女性有很强的联系，使用隐形眼镜，肠易激综合症，纤维肌痛，慢性疲劳综合症，包括白内障和激光屈光手术的眼科手术，圆锥角膜，骨关节炎，结缔组织疾病，动脉粥样硬化，格雷夫斯病，自闭症，抑郁症，倦怠，克罗恩病，结节病，扁平苔藓，酒渣鼻，肝硬化，睡眠呼吸暂停，鼻窦炎，甲状腺功能和空气污染（NO2）。高血压和高BMI与目前的吸烟程度和少干眼症密切相关，而吸烟者的干眼症也多。在干眼与血脂或血糖水平之间没有明确的联系。结论这项关于干眼症的研究证实但也驳斥了较小的流行病学研究中的许多危险因素，并在多种病因学类别中发现了许多新的危险因素。关于干眼症状在年轻人中特别常见的发现令人担忧，值得进一步研究。