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Meta-Analysis
. 2016 Jan 14;6(1):e009675.
doi: 10.1136/bmjopen-2015-009675.

Prevalence of dry eye disease in visual display terminal workers: a systematic review and meta-analysis

Romain Courtin  1 , Bruno Pereira  2 , Geraldine Naughton  3 , Alain Chamoux  4 , Frédéric Chiambaretta  5 , Charlotte Lanhers  4 , Frédéric Dutheil  6
Affiliations
Meta-Analysis

Prevalence of dry eye disease in visual display terminal workers: a systematic review and meta-analysis

Romain Courtin et al. BMJ Open. .

Abstract

Objective: To evaluate the prevalence and risk factors of dry eye disease (DED) in workers using visual display terminals (VDT).

Design: Systematic review and meta-analysis.

Data sources: We searched PubMed, Cochrane Library, Embase and Science Direct databases for studies reporting DED prevalence in VDT workers.

Results: 16 of the 9049 identified studies were included, with a total of 11,365 VDT workers. Despite a global DED prevalence of 49.5% (95% CI 47.5 to 50.6), ranging from 9.5% to 87.5%, important heterogeneity (I(2)=98.8%, p<0.0001) was observed. Variable diagnosis criteria used within studies were: questionnaires on symptoms, tear film anomalies and corneoconjunctival epithelial damage. Some studies combined criteria to define DED. Heterogeneous prevalence was associated with stratifications on symptoms (I(2)=98.7%, p<0.0001), tears (I(2)=98.5%, p<0.0001) and epithelial damage (I(2)=96.0%, p<0.0001). Stratification of studies with two criteria adjusted the prevalence to 54.0% (95% CI 52.1 to 55.9), whereas studies using three criteria resulted in a prevalence of 11.6% (95% CI 10.5 to 12.9). According to the literature, prevalence of DED was more frequent in females than in males and increased with age.

Conclusions: Owing to the disparity of the diagnosis criteria studied to define DED, the global prevalence of 49.5% lacked reliability because of the important heterogeneity. We highlight the necessity of implementing common DED diagnostic criteria to allow a more reliable estimation in order to develop the appropriate preventive occupational actions.

Keywords: OPHTHALMOLOGY; PREVENTIVE MEDICINE; PUBLIC HEALTH.

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Figures

Figure 1
Figure 1
Search strategy. DED, dry eye disease; VDT, visual display terminals.
Figure 2
Figure 2
Meta-analysis on the prevalence of dry eye disease in visual display terminal workers stratified on the three criteria defining dry eye disease: symptoms, tear anomalies and epithelial damage.
Figure 3
Figure 3
Meta-analysis on the prevalence of dry eye disease in visual display terminal workers stratified on diagnostic criteria for symptoms. OSDI, Ocular Index Disease Index.
Figure 4
Figure 4
Meta-analysis on the prevalence of dry eye disease in visual display terminal workers stratified on diagnostic criteria for tear film abnormalities. TBUT, tear break-up time.
Figure 5
Figure 5
Meta-analysis on the prevalence of DED in visual display terminal workers stratified on combining several diagnostic criteria. DED, dry eye disease.
See this image and copyright information in PMC

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