Subjective Dry Eye Symptoms in Pregnant Women-A SPEED Survey
Dry eye is a multifactorial ocular surface disorder characterized by a loss of homeostasis of the tear film, resulting in tear film instability, and ocular surface inflammation/damage. Several risk factors for dry eye, including older age, females, Asian ethnicity, contact lens wear, and hormonal imbalances have been reported. However, pregnancy as a specific risk factor for dry eye has not been well studied.
Studies report that during pregnancy, lacrimal gland growth factor expression can be altered and lacrimal acinar cells could be damaged, increasing the risk of dry eye. On the other hand, positive objective findings of dry eye among pregnant women with the absence of subjective findings are also reported. Women undergo significant emotional and physiological changes during pregnancy. Identifying and alleviating the symptoms related to dry eye can potentially improve the quality of life in pregnant women.
Earlier studies have identified the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire as a standardized valid instrument for identifying dry eye symptoms, its frequency and severity.
In this study, Divya Anantharaman et al investigated the prevalence of subjective dry eye symptoms among pregnant women by self-administration of the SPEED questionnaire.
The SPEED questionnaire was self-administered cross-sectionally to 428 pregnant women with clinically confirmed pregnancy from two obstetric clinics in Chennai, India. Subjects with predisposing risk factors for dry eye were excluded from the study. Subjects were categorized as normal, moderate, and severe dry eye based on the SPEED score.
Among the women, 48.5% of the subjects had symptoms like dryness, grittiness or scratchiness, soreness or irritation, burning or watering, or eye fatigue. About 2.3% had moderate dry eye according to SPEED questionnaire criteria. Eye fatigue was the most reported symptom and was present in 76.4% of women.
The symptom frequency score and severity score had a strong and significant correlation (r = 0:95, P <0.001). No significant correlation was noted among SPEED score vs age (r = −0:02, P>0.05). No significant correlation was found between symptoms of dry eye and gravidity (ρ = −0:006, P >0.05) and trimester (ρ = 0:38, P >0.05). Binary logistic regression showed that only occupational status and systemic condition was significantly associated with dry eye symptoms.
In study, authors administered the SPEED questionnaire and found that around half of the pregnant women reported having dry eye-related symptoms, like dryness, grittiness or scratchiness, burning or watering, soreness or irritation, eye fatigue of varying frequency and severity, despite the decreased prevalence of dry eye diagnosis score (SPEED score). However, according to the SPEED score criteria, only 1.2% of pregnant women had subjective symptoms of dry eye (moderate dry eye score).
The current study observed that coexisting systemic conditions, such as diabetes, hypertension, and thyroid disease, were significantly associated with the occurrence of dry eye symptoms. Further to that, the participants’ occupational status (P = 0:01) was found to be significantly related to the occurrence of dry eye symptoms.
The participants in their third trimester reported more symptoms, however not with statistical significance. In this study, more participants in their third trimester reported symptoms (n = 84) than those in other trimester. However, a statistically significant association between occurrence of dry eye symptoms and trimester was not found. The SPEED questionnaire used in this study was tested for the conceptual and semantic equivalence with Indian population; none of the participants in our study faced any difficulty while responding to the questionnaire. Administration of the SPEED questionnaire consumed less than five minutes of time. Strikingly, none of symptomatic participants (48.5%) were under any type of treatment to alleviate their symptoms, possibly due to the nonsevere nature of the symptoms
The prevalence of dry eye-related symptoms was found in about half of the surveyed pregnant women. Due to decreased severity of the symptoms and the infrequent occurrence of these symptoms, SPEED score-based dry eye diagnosis was found to be less among pregnant women. No significant difference was seen in symptoms or SPEED score among type of pregnancy, trimester, and systemic condition.
Source: Divya Anantharaman , Aiswaryah Radhakrishnan , and Vidhyalakshmi Anantharaman; Hindawi Journal of Pregnancy Volume 2023, Article ID 3421269, 7 pages https://doi.org/10.1155/2023/3421269
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