Estimation of Prevalence of Dry Eye Disease in Patients with Pterygium at a Tertiary Care Centre

Abstract

Background: Dry eye disease (DED) is a multifactorial disorder characterized by tear film instability, inflammation, and ocular surface damage, leading to discomfort and visual disturbance. Pterygium, a common degenerative ocular condition linked to ultraviolet exposure, shares overlapping mechanisms with DED, including chronic inflammation and tear film dysfunction. However, data on DED prevalence among pterygium patients in the Indian population remain limited. This study was conducted to estimate the prevalence of DED in patients with pterygium and evaluate its association with clinical and environmental risk factors. Methods: This hospital-based cross-sectional study was conducted at a tertiary care centre in Karnataka over a period of 18 months after receiving ethical clearance. A total of 100 clinically diagnosed pterygium patients underwent detailed ocular evaluation. DED assessment included the Ocular Surface Disease Index (OSDI), Schirmer’s test, Tear Break-Up Time (TBUT), Tear Meniscus Height (TMH), and ocular surface staining. Demographic details, occupational exposure, and environmental risk factors were recorded. Associations between DED and clinical parameters were analyzed. Results: Dry eye disease (DED) was observed in 62% of patients (RE: 54%, LE: 45%). Mean Schirmer’s values (~11–13 mm) and TBUT (~9.7–10.0 sec) indicated borderline tear function, with significantly lower values in DED cases (p < 0.001). TMH (~0.22 mm) was also significantly reduced in DED (p < 0.001). DED prevalence was 62%, with a significant association with pterygium grade (p <0.001), corneal encroachment (p =0.040), and reduced tear film parameters including Schirmer’s test, TBUT, and TMH (p <0.001). DED showed a significant association with corneal encroachment and pterygium severity (p ≤ 0.04; ANOVA p < 0.001) and with reduced best-corrected visual acuity (BCVA) (p < 0.001). Outdoor occupations had a higher DED risk (p < 0.05), while age, sex, residence, symptom duration, vascularity, and UV protection were not significant (p > 0.05). Conclusion: DED is highly prevalent in patients with pterygium and is closely associated with disease severity and environmental exposure. Routine screening and early management of DED are essential to improve patient comfort, enhance visual outcomes, and reduce postoperative complications.

Keywords: Dry eye disease, Pterygium, Tear film instability, Ocular surface disease, Prevalence, Tertiary care centre.