Prevalence and severity of dry eye disease among ophthalmologists and allied ocular care professionals

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Several studies have reported the prevalence of DED among the general population. The present study was conducted to investigate the prevalence of DED among ophthalmologists and allied ocular care professionals. Methods This cross-sectional study included ophthalmologists and allied ocular care professionals who attended the Emirates Society of Ophthalmology (ESO) conference in 2024 in the United Arab Emirates. Eligible participants were asked to complete the Dry Eye Questionnaire (DEQ-5), based on which the presence and severity of DED were assessed. Results The study included 203 participants (53.2% males), with the majority being ophthalmologists (47.8%), followed by nurses (17.2%), optometrists (13.8%), and others (21.2%). The overall prevalence of DED was 82.8%. It was significantly higher among females than males (88.4% vs 77.8%, p = 0.0460), and female optometrists had a 4.36-fold higher risk of DED than male optometrists (p = 0.0127). Regarding DED severity, 27.6% of the participants had mild DED, 35.5% had moderate DED, and 19.7% had severe DED. Females who worked as ophthalmologists (RR = 1.72, p = 0.0450) and those engaged in other professions (RR = 3.31, p = 0.0024) had a significantly higher risk of severe DED. Conclusion This study highlights alarmingly high rates of DED among ophthalmologists and allied ocular care professionals. Female professionals, particularly those who work as optometrists, have a significantly higher risk of DED than their male counterparts. Dry eye disease Cross-sectional study DEQ-5 survey/questionnaire prevalence severity United Arab Emirates 1. INTRODUCTION Dry eye disease (DED) occurs due to insufficient tear production, excessive tear evaporation, or instability of the tear film, among other etiologies [ 1 ]. If left unchecked, it can lead to ocular inflammation, corneal epithelial damage, neural structural and functional changes, and lid margin changes, all culminating in visual impairment [ 2 ]. There is substantial heterogeneity in the reported global prevalence of DED (5–50%) [ 3 ]. In a 2013 survey study in the United States, the prevalence of DED was reported as 6.8% [ 4 ]. Among females in the United Kingdom, it was 9.6%. A 2021 systematic review showed a DED prevalence rate among Asians of 20.1% [ 5 ]. These represent select examples of DED prevalence reports; however, the fact remains that nearly 50% of patients with confirmed DED do not receive appropriate treatment [ 6 ]. Risk factors for DED include patient demographic factors such as advanced age, female sex, and East Asian ethnicity [ 7 ] and lifestyle factors such as contact lens use [ 8 ], reduced sleep duration, and increased exposure to digital screens [ 9 ]. Research has suggested that an individual’s occupation may also predispose them to developing DED. Particularly, those working in construction, metal, and machinery industries, as well as those whose occupations require prolonged exposure to digital screens, are among the most vulnerable populations [ 10 ]. Given that knowledge of the symptoms of DED may positively influence healthcare seeking behaviors, the present study aimed to determine the prevalence of DED among ophthalmologists and allied ocular care professionals. Although several studies have been conducted to assess the prevalence of DED worldwide, we have, for the first time, investigated the prevalence of DED among ophthalmologists and allied ocular care professionals. 2. Methods 2.1 Study design This study employed a cross-sectional design and was conducted at the Emirates Society of Ophthalmology (ESO) conference in 2024 in Abu Dhabi, UAE. 2.2 Study objectives The primary objective of this study was to assess the prevalence and severity of DED among ophthalmologists and allied ocular care professionals who attended the ESO conference as a sample of ophthalmologist communities. The secondary objective was to investigate the associated risk factors (i.e., gender and profession) for DED among these individuals. 2.3 Study population and sample size calculation The study was conducted among ophthalmologists, optometrists, nurses, and other allied ocular care professionals who attended the ESO 2024 conference. The inclusion criteria required the participants to be either practising ophthalmologists or ophthalmology-related healthcare professionals and be fluent in English or Arabic language. Participants were excluded if they did not provide their consent to participate in the study. No formal sample size calculation was performed, and convenience sampling was performed. 2.4 Study measures 2.4.1 Presence and severity of DED The presence and severity of DED were assessed through the participants’ responses to the Dry Eye Questionnaire (DEQ-5), a validated questionnaire to evaluate DED severity [ 11 ]. The DEQ-5 questionnaire comprises five questions that evaluate “the frequency of watery eye, discomfort, and dryness” scored on a scale of 0 to 4 and “late-day discomfort and dryness intensity” scored on a scale of 0 to 5. All participants were asked to respond to the questionnaire on an iPad during one of the three days of the conference. The DEQ-5 score was calculated by summing the scores from each of the five questions in the questionnaire. Scores less than 6 indicated the absence of DED. A score of 6–8 indicated mild DED, 9–12 indicated moderate DED, and > 12 indicated severe DED. 2.5 Statistical analysis All collected data were anonymized and analyzed using Stata v17 (Stata Corp.). Participants with missing questionnaire data were excluded from the analysis. All categorical variables are presented as counts and percentages. The chi-square test was employed in the association analyses. The threshold for statistical significance was 0.05. 3. Results 3.1 Demographic characteristics of the participants The study included 203 participants. The participants involved in this study were mainly ophthalmologists (47.8%), followed by nurses (17.2%), optometrists (13.8%), and others (21.2%), including ocular health company owners, managers, and sales executives. There was no imbalance in gender distribution (males, 53.2%; females, 46.8%). In terms of country of practice, more than half of the participants attending the conference were from the UAE (58.6%). The demographic characteristics of the participants are presented in Table 1. Table 1. Demographic characteristics of the study participants Characteristic Profession Ophthalmologist Nurse Optometrist Others Overall Gender, n (%) Males 58 (53.7) 11 (10.2) 11 (10.2) 28 (25.9) 108 (53.2) Females 39 (41.1) 24 (25.3) 17 (17.9) 15 (15.8) 95 (46.8) Overall 97 (47.8) 35 (17.2) 28 (13.8) 43 (21.2) 203 (100.0) Country, n (%) UAE 49 (24.1) 26 (12.8) 21 (10.3) 23 (11.3) 119 (58.6) Egypt 17 (8.4) 0 (0) 0 (0) 1 (0.5) 18 (8.9) Saudi Arabia 5 (2.5) 0 (0) 0 (0) 3 (1.5) 8 (3.9) Oman 5 (2.5) 1 (0.5) 0 (0) 1 (0.5) 7 (3.4) USA 1 (0.5) 2 (1) 1 (0.5) 2 (1) 6 (3.0) Other countries a 12 (5.9) 2 (1) 1 (0.5) 5 (2.5) 20 (9.9) Missing 8 (3.9) 5 (2.5) 1 (0.5) 11 (5.4) 25 (12.3) a Other countries included: Bahrain (2%), India (2%), Romania (1%), Switzerland (0.5%), Syria (0.5%), Morocco (0.5%), Kuwait (0.5%), Iraq (0.5%), Algeria (0.5%), Dubai (0.5%), Lebanon (0.5%), Jordan (0.5%), and UK (0.5%). 3.2 Prevalence of DED Overall, DED of any severity was reported by 168/203 (82.8%) participants. The prevalence rates of DED by gender and profession are shown in Table 2. Among males, the prevalence of DED was 77.8%, and among females, it was 88.4%. In terms of profession, more than a third of ophthalmologists, nurses, and optometrists had DED. No significant association was observed between DED prevalence and profession (p = 0.3010); however, statistical analysis suggested that DED prevalence is significantly higher among females than males (p = 0.0460). Table 2. Prevalence rates of DED according to gender and profession. Stratification DED prevalence (%) Test statistic p-value Gender, n (%) z = -1.9951 0.0460 Males 84 (77.8) Females 84 (88.4) Profession, n (%) Chi-square = 3.6565 0.3010 Ophthalmologist 84 (86.6) Nurse 30 (85.8) Optometrist 22 (78.6) Other 32 (74.5) DED, dry eye disease To further assess the gender parity in DED prevalence and to investigate if females engaged in specific professions had a particularly higher risk of DED, we computed risk ratios (RRs) for each profession (Table 3). Table 3. DED risk between males and females belonging to different professions. Profession Female-to-male RR Chi-square p-value Overall 1.59 4.01 0.0452 Ophthalmologist 0.85 0.22 0.6384 Nurse 0.83 0.35 0.5521 Optometrist 4.36 6.21 0.0127 Other NA 7.92 0.0049 DED, dry eye disease; RR, risk ratio Regardless of profession, females had a 1.59-fold higher risk of DED than males, a significantly higher risk (p = 0.0452). However, this significantly higher risk among females was probably because of the significant difference between females and males who were working as optometrists. Female optometrists had a 4.36-fold higher risk of DED than male optometrists (p=0.0127). 3.3 DED severity Based on the participants’ responses to the DED questionnaire, we assessed the severity of DED. Overall, 56/203 (27.6%) participants had mild DED, 72/203 (35.5%) had moderate DED, and 40/203 (19.7%) had severe DED. Prevalence rates of DED of varying severities according to gender and profession are shown in Supplementary Table 1. Focusing on severe DED, we then checked if gender and profession influenced the prevalence of severe DED (Table 4). Table 4. Prevalence rates of severe DED according to gender and profession. Stratification Prevalence of severe DED Test statistic p-value Gender, n (%) z = -1.6629 0.0963 Males 13 (6.4) Females 27 (13.3) Profession, n (%) Chi-square = 9.40 0.0244 Ophthalmologist 18 (18.6) Nurse 8 (22.9) Optometrist 5 (17.9) Other 9 (20.9) DED, dry eye disease The prevalence of severe DED was higher among females, but the difference was not significant. On the other hand, we found a significant association between profession and prevalence of severe DED (p = 0.0244). As before, we investigated if gender parity could be observed within specific professions by computing female-to-male RRs for each profession (Table 5). Table 5. Risk of severe DED between males and females belonging to different professions. Profession Female-to-male RR Chi-square p-value Overall 1.62 8.58 0.0034 Ophthalmologist 1.72 4.02 0.0450 Nurse 0.89 0.18 0.6736 Optometrist 1.42 0.95 0.3299 Other 3.31 9.22 0.0024 DED, dry eye disease; RR, risk ratio Not stratifying by profession, the risk of severe DED was significantly higher among females than males (RR = 1.62, p = 0.0034). The significantly higher risk of severe DED among females was also noted for those who were ophthalmologists (RR = 1.72, p = 0.0450) and for those engaged in other professions (RR = 3.31, p = 0.0024). Discussion Although several studies on the prevalence of DED have been conducted among the general population, we believe this is the first study reporting the prevalence of DED among ophthalmologists and allied ocular care professionals. Nearly half of the study participants were practicing ophthalmologists, and almost 60% of the participants were from the UAE, which was the host location for the conference. The overall DED prevalence rate of 82.8% reported in our study among ophthalmologists and allied ocular care professionals is much higher than rates reported for the general population, namely 28.3% in the Middle East [ 12 ], 32.1% in the UK [ 13 ], and 8.1% in the USA [ 14 ]. A lack of awareness of DED symptoms has been highlighted as a concern, with nearly 71.5% of the participants in a previous study in Saudi Arabia demonstrating poor awareness [ 15 ]. Beyond the general population, a lack of awareness among general physicians has also been documented. Poor awareness prevents prompt referral to an eye specialist and, therefore, diagnosis of the condition, which results in greater patient discomfort and ultimately visual damage [ 16 ]. However, what stands out in the present study is that more than 8 out of every 10 ocular health professionals had DED despite their presumed good understanding of the condition and its risk factors. The prevalence of DED has indeed been reported to differ between males and females. In a large, representative population-based study in the US, the prevalence of DED was under 3% in males but nearly 8% in females [ 17 ]. A systematic review assessing DED prevalence among Asian populations also reported a higher DED prevalence rate of 21.7% compared to 16.4% in males [ 5 ]. DED is known to be more prevalent in women, especially those experiencing menopause and postmenopause, due to hormonal fluctuations and their impact on tear production and the ocular surface [ 18 ]. Even in the present study, females had a significantly higher DED prevalence than males, regardless of their profession. In particular, the difference between males and females in DED prevalence was most pronounced among optometrists. Female optometrists had a 4-fold higher risk of DED than male optometrists. Female professionals may be more likely to report discomfort and workplace dissatisfaction than male professionals [ 19 ], but whether they are indeed more vulnerable to occupational hazards related to musculoskeletal disorders and eye strain is not well supported by published evidence. Anecdotal reports suggest greater work-related physical discomfort among female optometrists than their male counterparts [ 20 ]. A cross-sectional survey among ophthalmologists in the USA showed that close to 40% experienced burnout [ 21 ]. Moreover, female ophthalmologists were twice as likely as males to experience burnout. These results align with the alarmingly high rates of DED among ophthalmologists and allied ocular care professionals, as well as the higher prevalence of DED among females than males. Beyond the disproportionately high reporting of DED prevalence among females, the evolving nature of the tasks of an eye care specialist warrants some discussion. Focusing on the role of an ophthalmologist or an optometrist, changes in work processes and the increasing use of computers progressively increase visual demand and the activation of the components of the nervous system that coordinate eye movements and accommodation. Excessive screen time can cause digital eye strain, also known as computer vision syndrome. Nearly half of all users of a computer screen or an electronic device that produces visual information are reported to develop DED worldwide [ 22 ]. Dry eyes, a common symptom of digital eye strain, occur because people tend to blink less frequently when focused on screens, reducing the lubrication and moisture of the eyes [ 23 ]. The tasks performed by ophthalmologists and optometrists involve considerable visual effort. Visual demands, especially for near vision, are becoming increasingly more common at the workplace. In a study conducted among ophthalmologists at a university hospital in Lisbon, all participating ophthalmologists reported symptoms of DED, and 30% of them reported feeling their eyes dry “frequently” [ 24 ]. The environment also plays a role in the development of DED. Most previous studies reporting the negative effects of ambient temperature, air pollutants, suspended particulate matter, and aeroallergens (including pollen grains) have been conducted in outdoor settings [ 25 ]. Given that we spend increasingly more time indoors, especially when working in clinics and hospitals, it would be more relevant to consider the effect of indoor temperature, humidity, and lighting on the onset of DED among ophthalmologists and allied ocular healthcare professionals. The relative humidity decreases in enclosed environments, especially those with air conditioning systems, which accelerates the evaporation of tears [ 24 ]. This situation might be exacerbated by the visual effort imposed by work at near distance over a long period of time, which inevitably results in a reduction in blink rate. The severity of DED is often assessed using the DEQ-5, which evaluates the level of irritation, frequency of irritation, intensity of the irritation in the morning, and intensity of the irritation late in the day. Moderate-to-severe DED can cause substantial ocular pain, which can limit daily activities and impair quality of life [ 26 ]. Depression is known to be associated with more severe DED symptoms [ 27 ]. The high rates of emotional exhaustion among ophthalmologists could also have contributed to the increased proportion of professionals reporting moderate and severe DED [ 28 ]. In the present study, the proportion of participants reporting severe DED did not differ significantly between males and females; however, females had a 1.6-fold higher risk of experiencing severe DED than males, regardless of their profession. There was also a significant influence of the type of ophthalmology profession on the prevalence of severe DED. The difference in the prevalence of severe DED between males and females was substantial among ophthalmologists. Some limitations of this study must be acknowledged. First, the participants of this study were recruited from among those who attended the ESO 2024 conference. Therefore, the study population may not be representative of the broader community of ophthalmologists and allied ocular health professionals. Second, the age of the participants was not captured. It is well known that the risk of DED increases with age [ 29 ]. Similarly, years of practice would have also been interesting to valuable to examine. It would be worthwhile to investigate the association between DED prevalence and years of practice to better understand if DED represents an occupational hazard. Third, DED was diagnosed based only on the participants’ responses to the DEQ, and no clinical examination was performed to confirm the diagnosis. A future study could incorporate clinical assessments. Fourth, no information regarding current medication use, comorbidities, and medical history of the participants was recorded. Fifth, even though we gathered data on the country of practice of the participants, we noticed a skewed distribution. More than half of the participants were from the UAE. This could be because of the convenience for local professionals to attend the conference. Therefore, we did not investigate the effect of country of practice on DED prevalence in our study. Conclusion The prevalence of DED among ophthalmologists and allied ocular care professionals was found to be 82%. Female professionals, particularly those who work as optometrists, have a significantly higher risk of DED than their male counterparts. Future studies should investigate workplace-related aspects of ocular care professionals to explore additional risk factors for DED among these professionals. Declarations Acknowledgement Medical writing and editorial support was provided by Vinay Sridhar (M.Pharm., CMPP, ELS), a freelance medical writer based in Mumbai, India. Funding The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Competing interests The authors have no relevant financial or non-financial interests to disclose. Author contributions A.A.H., M.A., H.S.AD., N.AQ., A.K., and O.H. conceptualized the study. A.AS., N.H., and T.H.C. collected and analyzed the data. A.AS. and O.H. interpreted the data. A.AS. wrote the first draft of the manuscript. All authors provided intellectual input to revise the draft. They reviewed and approved the final draft of the manuscript. Ethics approval This is an observational study. The Research Ethics Committee of Sheikh Shakhbout Medical City has confirmed that no ethical approval is required. Consent to participate Informed consent was obtained from all individual participants included in the study. Consent to publish Not applicable References Javadi M-A, Feizi S (2011) Dry Eye Syndrome. J Ophthalmic Vis Res 6:192–198 Aragona P, Giannaccare G, Mencucci R, et al (2021) Modern approach to the treatment of dry eye, a complex multifactorial disease: a P.I.C.A.S.S.O. board review. Br J Ophthalmol 105:446–453. https://doi.org/10.1136/bjophthalmol-2019-315747 Sheppard J, Shen Lee B, Periman LM (2023) Dry eye disease: identification and therapeutic strategies for primary care clinicians and clinical specialists. 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Supplementary Files SupplementaryTable1.docx Cite Share Download PDF Status: Published Journal Publication published 16 Feb, 2026 Read the published version in International Ophthalmology → Version 1 posted Editorial decision: Revision requested 15 Nov, 2025 Reviews received at journal 15 Nov, 2025 Reviews received at journal 14 Nov, 2025 Reviewers agreed at journal 11 Nov, 2025 Reviewers agreed at journal 11 Nov, 2025 Reviews received at journal 11 Nov, 2025 Reviewers agreed at journal 10 Nov, 2025 Reviewers agreed at journal 10 Nov, 2025 Reviewers agreed at journal 10 Nov, 2025 Reviewers invited by journal 10 Nov, 2025 Editor assigned by journal 01 Sep, 2025 Submission checks completed at journal 01 Sep, 2025 First submitted to journal 31 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Ophthalmology","correspondingAuthor":false,"prefix":"","firstName":"Khaled","middleName":"","lastName":"Abuhaleeqa","suffix":""},{"id":545686478,"identity":"fd9eafab-f0a0-4b48-ae5d-166ea7df9315","order_by":8,"name":"Omnia Hamam","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA40lEQVRIiWNgGAWjYJCCA2DEwMD4AEjw8JGihdkApIWNeIsYGNgkwCQhtfxiZw8e+MFwR163/XRa5dccOxk2BuaHj27g0SI5Oy/hYA/DM8NtZ3K33Zbdlgx0GJuxcQ4eLQa3cwwO8DAcZtx2AKhFchszUAsPmzQhLQf/MBy233b+7bZiyW31xGk5DLQlcduN3G2MH7cdJqxFcjZQi4zB4eRtN95ulmbcdpyHjZmAX/ilc4w/vqk4bLvtfO7Gjz+3Vdvzszc/fIxPC9R5EIqZB0wSVI4EGH+QonoUjIJRMApGDAAA+kxMqZRq6jEAAAAASUVORK5CYII=","orcid":"","institution":"Sheikh Shakhbout Medical City","correspondingAuthor":true,"prefix":"","firstName":"Omnia","middleName":"","lastName":"Hamam","suffix":""}],"badges":[],"createdAt":"2025-08-31 11:38:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7500263/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7500263/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s10792-026-03981-4","type":"published","date":"2026-02-16T15:59:41+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":96388248,"identity":"9af4d690-dc21-4325-939b-6f06d89fd36d","added_by":"auto","created_at":"2025-11-20 13:48:29","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":86035,"visible":true,"origin":"","legend":"","description":"","filename":"Manuscript.docx","url":"https://assets-eu.researchsquare.com/files/rs-7500263/v1/61ccba6b5f6e12d143cc43e0.docx"},{"id":96454177,"identity":"bbe81ade-a611-465b-8cf6-6cc3036bcf87","added_by":"auto","created_at":"2025-11-21 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16:08:25","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":881968,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7500263/v1/cc1976b7-a21f-4806-92e7-0dab0857344e.pdf"},{"id":96388249,"identity":"e76a30c8-14f6-4f41-9846-0e7a093ec8d4","added_by":"auto","created_at":"2025-11-20 13:48:29","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":15167,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryTable1.docx","url":"https://assets-eu.researchsquare.com/files/rs-7500263/v1/71719acca774a5aaf021ddcf.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence and severity of dry eye disease among ophthalmologists and allied ocular care professionals","fulltext":[{"header":"1. INTRODUCTION","content":"\u003cp\u003eDry eye disease (DED) occurs due to insufficient tear production, excessive tear evaporation, or instability of the tear film, among other etiologies [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. If left unchecked, it can lead to ocular inflammation, corneal epithelial damage, neural structural and functional changes, and lid margin changes, all culminating in visual impairment [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. There is substantial heterogeneity in the reported global prevalence of DED (5\u0026ndash;50%) [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In a 2013 survey study in the United States, the prevalence of DED was reported as 6.8% [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Among females in the United Kingdom, it was 9.6%. A 2021 systematic review showed a DED prevalence rate among Asians of 20.1% [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. These represent select examples of DED prevalence reports; however, the fact remains that nearly 50% of patients with confirmed DED do not receive appropriate treatment [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eRisk factors for DED include patient demographic factors such as advanced age, female sex, and East Asian ethnicity [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] and lifestyle factors such as contact lens use [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], reduced sleep duration, and increased exposure to digital screens [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Research has suggested that an individual\u0026rsquo;s occupation may also predispose them to developing DED. Particularly, those working in construction, metal, and machinery industries, as well as those whose occupations require prolonged exposure to digital screens, are among the most vulnerable populations [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Given that knowledge of the symptoms of DED may positively influence healthcare seeking behaviors, the present study aimed to determine the prevalence of DED among ophthalmologists and allied ocular care professionals.\u003c/p\u003e\u003cp\u003eAlthough several studies have been conducted to assess the prevalence of DED worldwide, we have, for the first time, investigated the prevalence of DED among ophthalmologists and allied ocular care professionals.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Study design\u003c/h2\u003e\u003cp\u003eThis study employed a cross-sectional design and was conducted at the Emirates Society of Ophthalmology (ESO) conference in 2024 in Abu Dhabi, UAE.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Study objectives\u003c/h2\u003e\u003cp\u003e The primary objective of this study was to assess the prevalence and severity of DED among ophthalmologists and allied ocular care professionals who attended the ESO conference as a sample of ophthalmologist communities. The secondary objective was to investigate the associated risk factors (i.e., gender and profession) for DED among these individuals.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Study population and sample size calculation\u003c/h2\u003e\u003cp\u003e The study was conducted among ophthalmologists, optometrists, nurses, and other allied ocular care professionals who attended the ESO 2024 conference. The inclusion criteria required the participants to be either practising ophthalmologists or ophthalmology-related healthcare professionals and be fluent in English or Arabic language. Participants were excluded if they did not provide their consent to participate in the study.\u003c/p\u003e\u003cp\u003eNo formal sample size calculation was performed, and convenience sampling was performed.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Study measures\u003c/h2\u003e\u003cdiv id=\"Sec7\" class=\"Section3\"\u003e\u003ch2\u003e2.4.1 Presence and severity of DED\u003c/h2\u003e\u003cp\u003eThe presence and severity of DED were assessed through the participants\u0026rsquo; responses to the Dry Eye Questionnaire (DEQ-5), a validated questionnaire to evaluate DED severity [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The DEQ-5 questionnaire comprises five questions that evaluate \u0026ldquo;the frequency of watery eye, discomfort, and dryness\u0026rdquo; scored on a scale of 0 to 4 and \u0026ldquo;late-day discomfort and dryness intensity\u0026rdquo; scored on a scale of 0 to 5. All participants were asked to respond to the questionnaire on an iPad during one of the three days of the conference.\u003c/p\u003e\u003cp\u003eThe DEQ-5 score was calculated by summing the scores from each of the five questions in the questionnaire. Scores less than 6 indicated the absence of DED. A score of 6\u0026ndash;8 indicated mild DED, 9\u0026ndash;12 indicated moderate DED, and \u0026gt;\u0026thinsp;12 indicated severe DED.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e2.5 Statistical analysis\u003c/h2\u003e\u003cp\u003eAll collected data were anonymized and analyzed using Stata v17 (Stata Corp.). Participants with missing questionnaire data were excluded from the analysis. All categorical variables are presented as counts and percentages. The chi-square test was employed in the association analyses. The threshold for statistical significance was 0.05.\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003ch2\u003e3.1 Demographic characteristics of the participants\u003c/h2\u003e\n\u003cp\u003eThe study included 203 participants. The participants involved in this study were mainly ophthalmologists (47.8%), followed by nurses (17.2%), optometrists (13.8%), and others (21.2%), including ocular health company owners, managers, and sales executives. There was no imbalance in gender distribution (males, 53.2%; females, 46.8%). In terms of country of practice, more than half of the participants attending the conference were from the UAE (58.6%). The demographic characteristics of the participants are presented in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1. Demographic characteristics of the study participants\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eCharacteristic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 515px;\"\u003e\n \u003cp\u003eProfession\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003eOphthalmologist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003eOptometrist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003eOverall\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" style=\"width: 624px;\"\u003e\n \u003cp\u003eGender, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eMales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e58 (53.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e11 (10.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e11 (10.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e28 (25.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e108 (53.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eFemales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e39 (41.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e24 (25.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e17 (17.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e15 (15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e95 (46.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eOverall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e97 (47.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e35 (17.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e28 (13.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e43 (21.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e203 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" style=\"width: 624px;\"\u003e\n \u003cp\u003eCountry, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eUAE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;49 (24.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e26 (12.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e21 (10.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e23 (11.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e119 (58.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eEgypt\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e17 (8.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e18 (8.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eSaudi Arabia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e5 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e3 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e8 (3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eOman\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e5 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e1 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e7 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e1 (0.5)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e2 (1)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e1 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e6 (3.0)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eOther countries \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e12 (5.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e2 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e1 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e5 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e20 (9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eMissing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e8 (3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e5 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e1 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e11 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e25 (12.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e Other countries included: Bahrain (2%), India (2%), Romania (1%), Switzerland (0.5%), Syria (0.5%), Morocco (0.5%), Kuwait (0.5%), Iraq (0.5%), Algeria (0.5%), Dubai (0.5%), Lebanon (0.5%), Jordan (0.5%), and UK (0.5%).\u003c/p\u003e\n\u003ch2\u003e3.2 Prevalence of DED\u003c/h2\u003e\n\u003cp\u003eOverall, DED of any severity was reported by 168/203 (82.8%) participants. The prevalence rates of DED by gender and profession are shown in Table 2. Among males, the prevalence of DED was 77.8%, and among females, it was 88.4%. In terms of profession, more than a third of ophthalmologists, nurses, and optometrists had DED. No significant association was observed between DED prevalence and profession (p = 0.3010); however, statistical analysis suggested that DED prevalence is significantly higher among females than males (p = 0.0460).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Prevalence rates of DED according to gender and profession.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStratification\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDED prevalence (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 170px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest statistic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003eGender, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 170px;\"\u003e\n \u003cp\u003ez = -1.9951\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e0.0460\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003eMales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e84 (77.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003eFemales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e84 (88.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003eProfession, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 170px;\"\u003e\n \u003cp\u003eChi-square = 3.6565\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e0.3010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003eOphthalmologist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e84 (86.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e30 (85.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003eOptometrist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e22 (78.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e32 (74.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eDED, dry eye disease\u003c/p\u003e\n\u003cp\u003eTo further assess the gender parity in DED prevalence and to investigate if females engaged in specific professions had a particularly higher risk of DED, we computed risk ratios (RRs) for each profession (Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. DED risk between males and females belonging to different professions.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProfession\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale-to-male RR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChi-square\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eOverall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e1.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e4.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0452\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eOphthalmologist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e0.6384\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e0.5521\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eOptometrist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e4.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e6.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0127\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e7.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0049\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eDED, dry eye disease; RR, risk ratio\u003c/p\u003e\n\u003cp\u003eRegardless of profession, females had a 1.59-fold higher risk of DED than males, a significantly higher risk (p = 0.0452). However, this significantly higher risk among females was probably because of the significant difference between females and males who were working as optometrists. Female optometrists had a 4.36-fold higher risk of DED than male optometrists (p=0.0127).\u003c/p\u003e\n\u003ch2\u003e3.3 DED severity\u003c/h2\u003e\n\u003cp\u003eBased on the participants\u0026rsquo; responses to the DED questionnaire, we assessed the severity of DED. Overall, 56/203 (27.6%) participants had mild DED, 72/203 (35.5%) had moderate DED, and 40/203 (19.7%) had severe DED. Prevalence rates of DED of varying severities according to gender and profession are shown in Supplementary Table 1.\u003c/p\u003e\n\u003cp\u003eFocusing on severe DED, we then checked if gender and profession influenced the prevalence of severe DED (Table 4).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Prevalence rates of severe DED according to gender and profession.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eStratification\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003ePrevalence of severe DED\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eTest statistic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eGender, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003ez = -1.6629\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e0.0963\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eMales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e13 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eFemales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e27 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eProfession, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eChi-square = 9.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0244\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eOphthalmologist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e18 (18.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e8 (22.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eOptometrist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e5 (17.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e9 (20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eDED, dry eye disease\u003c/p\u003e\n\u003cp\u003eThe prevalence of severe DED was higher among females, but the difference was not significant. On the other hand, we found a significant association between profession and prevalence of severe DED (p = 0.0244). As before, we investigated if gender parity could be observed within specific professions by computing female-to-male RRs for each profession (Table 5).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5. Risk of severe DED between males and females belonging to different professions.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProfession\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale-to-male RR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChi-square\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eOverall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.62\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e8.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0034\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eOphthalmologist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.72\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e4.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0450\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e0.6736\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eOptometrist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e0.3299\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.31\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e9.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0024\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eDED, dry eye disease; RR, risk ratio\u003c/p\u003e\n\u003cp\u003eNot stratifying by profession, the risk of severe DED was significantly higher among females than males (RR = 1.62, p = 0.0034). The significantly higher risk of severe DED among females was also noted for those who were ophthalmologists (RR = 1.72, p = 0.0450) and for those engaged in other professions (RR = 3.31, p = 0.0024).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eAlthough several studies on the prevalence of DED have been conducted among the general population, we believe this is the first study reporting the prevalence of DED among ophthalmologists and allied ocular care professionals. Nearly half of the study participants were practicing ophthalmologists, and almost 60% of the participants were from the UAE, which was the host location for the conference. The overall DED prevalence rate of 82.8% reported in our study among ophthalmologists and allied ocular care professionals is much higher than rates reported for the general population, namely 28.3% in the Middle East [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], 32.1% in the UK [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], and 8.1% in the USA [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eA lack of awareness of DED symptoms has been highlighted as a concern, with nearly 71.5% of the participants in a previous study in Saudi Arabia demonstrating poor awareness [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Beyond the general population, a lack of awareness among general physicians has also been documented. Poor awareness prevents prompt referral to an eye specialist and, therefore, diagnosis of the condition, which results in greater patient discomfort and ultimately visual damage [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. However, what stands out in the present study is that more than 8 out of every 10 ocular health professionals had DED despite their presumed good understanding of the condition and its risk factors.\u003c/p\u003e\u003cp\u003eThe prevalence of DED has indeed been reported to differ between males and females. In a large, representative population-based study in the US, the prevalence of DED was under 3% in males but nearly 8% in females [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. A systematic review assessing DED prevalence among Asian populations also reported a higher DED prevalence rate of 21.7% compared to 16.4% in males [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. DED is known to be more prevalent in women, especially those experiencing menopause and postmenopause, due to hormonal fluctuations and their impact on tear production and the ocular surface [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Even in the present study, females had a significantly higher DED prevalence than males, regardless of their profession. In particular, the difference between males and females in DED prevalence was most pronounced among optometrists. Female optometrists had a 4-fold higher risk of DED than male optometrists.\u003c/p\u003e\u003cp\u003eFemale professionals may be more likely to report discomfort and workplace dissatisfaction than male professionals [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], but whether they are indeed more vulnerable to occupational hazards related to musculoskeletal disorders and eye strain is not well supported by published evidence. Anecdotal reports suggest greater work-related physical discomfort among female optometrists than their male counterparts [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. A cross-sectional survey among ophthalmologists in the USA showed that close to 40% experienced burnout [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Moreover, female ophthalmologists were twice as likely as males to experience burnout. These results align with the alarmingly high rates of DED among ophthalmologists and allied ocular care professionals, as well as the higher prevalence of DED among females than males.\u003c/p\u003e\u003cp\u003eBeyond the disproportionately high reporting of DED prevalence among females, the evolving nature of the tasks of an eye care specialist warrants some discussion. Focusing on the role of an ophthalmologist or an optometrist, changes in work processes and the increasing use of computers progressively increase visual demand and the activation of the components of the nervous system that coordinate eye movements and accommodation. Excessive screen time can cause digital eye strain, also known as computer vision syndrome. Nearly half of all users of a computer screen or an electronic device that produces visual information are reported to develop DED worldwide [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Dry eyes, a common symptom of digital eye strain, occur because people tend to blink less frequently when focused on screens, reducing the lubrication and moisture of the eyes [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The tasks performed by ophthalmologists and optometrists involve considerable visual effort. Visual demands, especially for near vision, are becoming increasingly more common at the workplace. In a study conducted among ophthalmologists at a university hospital in Lisbon, all participating ophthalmologists reported symptoms of DED, and 30% of them reported feeling their eyes dry \u0026ldquo;frequently\u0026rdquo; [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe environment also plays a role in the development of DED. Most previous studies reporting the negative effects of ambient temperature, air pollutants, suspended particulate matter, and aeroallergens (including pollen grains) have been conducted in outdoor settings [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Given that we spend increasingly more time indoors, especially when working in clinics and hospitals, it would be more relevant to consider the effect of indoor temperature, humidity, and lighting on the onset of DED among ophthalmologists and allied ocular healthcare professionals. The relative humidity decreases in enclosed environments, especially those with air conditioning systems, which accelerates the evaporation of tears [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. This situation might be exacerbated by the visual effort imposed by work at near distance over a long period of time, which inevitably results in a reduction in blink rate.\u003c/p\u003e\u003cp\u003eThe severity of DED is often assessed using the DEQ-5, which evaluates the level of irritation, frequency of irritation, intensity of the irritation in the morning, and intensity of the irritation late in the day. Moderate-to-severe DED can cause substantial ocular pain, which can limit daily activities and impair quality of life [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Depression is known to be associated with more severe DED symptoms [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The high rates of emotional exhaustion among ophthalmologists could also have contributed to the increased proportion of professionals reporting moderate and severe DED [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. In the present study, the proportion of participants reporting severe DED did not differ significantly between males and females; however, females had a 1.6-fold higher risk of experiencing severe DED than males, regardless of their profession. There was also a significant influence of the type of ophthalmology profession on the prevalence of severe DED. The difference in the prevalence of severe DED between males and females was substantial among ophthalmologists.\u003c/p\u003e\u003cp\u003eSome limitations of this study must be acknowledged. First, the participants of this study were recruited from among those who attended the ESO 2024 conference. Therefore, the study population may not be representative of the broader community of ophthalmologists and allied ocular health professionals. Second, the age of the participants was not captured. It is well known that the risk of DED increases with age [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Similarly, years of practice would have also been interesting to valuable to examine. It would be worthwhile to investigate the association between DED prevalence and years of practice to better understand if DED represents an occupational hazard. Third, DED was diagnosed based only on the participants\u0026rsquo; responses to the DEQ, and no clinical examination was performed to confirm the diagnosis. A future study could incorporate clinical assessments. Fourth, no information regarding current medication use, comorbidities, and medical history of the participants was recorded. Fifth, even though we gathered data on the country of practice of the participants, we noticed a skewed distribution. More than half of the participants were from the UAE. This could be because of the convenience for local professionals to attend the conference. Therefore, we did not investigate the effect of country of practice on DED prevalence in our study.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe prevalence of DED among ophthalmologists and allied ocular care professionals was found to be 82%. Female professionals, particularly those who work as optometrists, have a significantly higher risk of DED than their male counterparts. Future studies should investigate workplace-related aspects of ocular care professionals to explore additional risk factors for DED among these professionals.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMedical writing and editorial support was provided by Vinay Sridhar (M.Pharm., CMPP, ELS), a freelance medical writer based in Mumbai, India.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA.A.H., M.A., H.S.AD., N.AQ., A.K., and O.H. conceptualized the study. A.AS., N.H., and T.H.C. collected and analyzed the data. A.AS. and O.H. interpreted the data. A.AS. wrote the first draft of the manuscript. All authors provided intellectual input to revise the draft. They reviewed and approved the final draft of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis is an observational study. The Research Ethics Committee of Sheikh Shakhbout Medical City has confirmed that no ethical approval is required.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all individual participants included in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publish\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eJavadi M-A, Feizi S (2011) Dry Eye Syndrome. J Ophthalmic Vis Res 6:192\u0026ndash;198\u003c/li\u003e\n\u003cli\u003eAragona P, Giannaccare G, Mencucci R, et al (2021) Modern approach to the treatment of dry eye, a complex multifactorial disease: a P.I.C.A.S.S.O. board review. Br J Ophthalmol 105:446\u0026ndash;453. https://doi.org/10.1136/bjophthalmol-2019-315747\u003c/li\u003e\n\u003cli\u003eSheppard J, Shen Lee B, Periman LM (2023) Dry eye disease: identification and therapeutic strategies for primary care clinicians and clinical specialists. Ann Med 55:241\u0026ndash;252. https://doi.org/10.1080/07853890.2022.2157477\u003c/li\u003e\n\u003cli\u003eFarrand KF, Fridman M, Stillman I\u0026Ouml;, Schaumberg DA (2017) Prevalence of Diagnosed Dry Eye Disease in the United States Among Adults Aged 18 Years and Older. Am J Ophthalmol 182:90\u0026ndash;98. https://doi.org/10.1016/j.ajo.2017.06.033\u003c/li\u003e\n\u003cli\u003eCai Y, Wei J, Zhou J, Zou W (2022) Prevalence and Incidence of Dry Eye Disease in Asia: A Systematic Review and Meta-Analysis. Ophthalmic Res 65:647\u0026ndash;658. https://doi.org/10.1159/000525696\u003c/li\u003e\n\u003cli\u003eVerjee MA, Brissette AR, Starr CE (2020) Dry Eye Disease: Early Recognition with Guidance on Management and Treatment for Primary Care Family Physicians. Ophthalmol Ther 9:877\u0026ndash;888. https://doi.org/10.1007/s40123-020-00308-z\u003c/li\u003e\n\u003cli\u003eBritten-Jones AC, Wang MTM, Samuels I, et al (2024) Epidemiology and Risk Factors of Dry Eye Disease: Considerations for Clinical Management. Medicina (Mex) 60:1458. https://doi.org/10.3390/medicina60091458\u003c/li\u003e\n\u003cli\u003eQian L, Wei W (2022) Identified risk factors for dry eye syndrome: A systematic review and meta-analysis. PLOS ONE 17:e0271267. https://doi.org/10.1371/journal.pone.0271267\u003c/li\u003e\n\u003cli\u003eWolffsohn JS, Wang MTM, Vidal-Rohr M, et al (2021) Demographic and lifestyle risk factors of dry eye disease subtypes: A cross-sectional study. Ocul Surf 21:58\u0026ndash;63. https://doi.org/10.1016/j.jtos.2021.05.001\u003c/li\u003e\n\u003cli\u003eBazeer S, Jansonius N, Snieder H, et al (2019) The relationship between occupation and dry eye. Ocul Surf 17:484\u0026ndash;490. https://doi.org/10.1016/j.jtos.2019.04.004\u003c/li\u003e\n\u003cli\u003eKadiri B, Vivekanand U, Lobo SR (2024) Comparative analysis of Dry Eye Questionnaire 5 and Ocular Surface Disease Index in assessing dry eye symptoms. J Clin Ophthalmol Res 12:130. https://doi.org/10.4103/jcor.jcor_149_23\u003c/li\u003e\n\u003cli\u003eMohamed Z, Alrasheed S, Abdu M, Allinjawi K (2024) Dry Eye Disease Prevalence and Associated Risk Factors Among the Middle East Population: A Systematic Review and Meta-Analysis. Cureus. https://doi.org/10.7759/cureus.70522\u003c/li\u003e\n\u003cli\u003eVidal-Rohr M, Craig JP, Davies LN, Wolffsohn JS (2023) The epidemiology of dry eye disease in the UK: The Aston dry eye study. Contact Lens Anterior Eye J Br Contact Lens Assoc 46:101837. https://doi.org/10.1016/j.clae.2023.101837\u003c/li\u003e\n\u003cli\u003eMcCann P, Abraham AG, Mukhopadhyay A, et al (2022) Prevalence and Incidence of Dry Eye and Meibomian Gland Dysfunction in the United States: A Systematic Review and Meta-analysis. JAMA Ophthalmol 140:1181\u0026ndash;1192. https://doi.org/10.1001/jamaophthalmol.2022.4394\u003c/li\u003e\n\u003cli\u003eAlSomali AI, Alsaad MA, Alshammary AA, et al Awareness About Dry Eye Symptoms and Risk Factors Among Eastern Province Population in Saudi Arabia. Cureus 15:e48197. https://doi.org/10.7759/cureus.48197\u003c/li\u003e\n\u003cli\u003eVerjee MA, Brissette AR, Starr CE (2020) Dry Eye Disease: Early Recognition with Guidance on Management and Treatment for Primary Care Family Physicians. Ophthalmol Ther 9:877\u0026ndash;888. https://doi.org/10.1007/s40123-020-00308-z\u003c/li\u003e\n\u003cli\u003eDana R, Bradley JL, Guerin A, et al (2019) Estimated Prevalence and Incidence of Dry Eye Disease Based on Coding Analysis of a Large, All-age United States Health Care System. Am J Ophthalmol 202:47\u0026ndash;54. https://doi.org/10.1016/j.ajo.2019.01.026\u003c/li\u003e\n\u003cli\u003eMatossian C, McDonald M, Donaldson KE, et al (2019) Dry Eye Disease: Consideration for Women\u0026rsquo;s Health. J Womens Health 28:502\u0026ndash;514. https://doi.org/10.1089/jwh.2018.7041\u003c/li\u003e\n\u003cli\u003eAuer E, Marx K, Kaufman J, et al (2025) Exploring gender differences in professional well-being among U.S. optometrists. Optom Vis Sci 102:458. https://doi.org/10.1097/OPX.0000000000002270\u003c/li\u003e\n\u003cli\u003eLong J, Naduvilath TJ, Hao LE, et al (2011) Risk factors for physical discomfort in Australian optometrists. Optom Vis Sci Off Publ Am Acad Optom 88:317\u0026ndash;326. https://doi.org/10.1097/OPX.0b013e3182045a8e\u003c/li\u003e\n\u003cli\u003eSedhom JA, Patnaik JL, McCourt EA, et al (2022) Physician burnout in ophthalmology: U.S. survey. J Cataract Refract Surg 48:723\u0026ndash;729. https://doi.org/10.1097/j.jcrs.0000000000000837\u003c/li\u003e\n\u003cli\u003eCourtin R, Pereira B, Naughton G, et al (2016) Prevalence of dry eye disease in visual display terminal workers: a systematic review and meta-analysis. BMJ Open 6:e009675. https://doi.org/10.1136/bmjopen-2015-009675\u003c/li\u003e\n\u003cli\u003eAl S, Js W (2018) Digital eye strain: prevalence, measurement and amelioration. BMJ Open Ophthalmol 3:. https://doi.org/10.1136/bmjophth-2018-000146\u003c/li\u003e\n\u003cli\u003eDzhodzhua V, Serranheira F, Leite ES, et al (2017) Visual demands and visual fatigue among ophthalmologists. Rev Bras Med Trab 15:209\u0026ndash;216. https://doi.org/10.5327/Z1679443520170013\u003c/li\u003e\n\u003cli\u003ePatel S, Mittal R, Kumar N, Galor A (2023) The environment and dry eye\u0026mdash;manifestations, mechanisms, and more. Front Toxicol 5:1173683. https://doi.org/10.3389/ftox.2023.1173683\u003c/li\u003e\n\u003cli\u003eAsbell P, Messmer E, Chan C, et al (2019) Defining the needs and preferences of patients with dry eye disease. BMJ Open Ophthalmol 4:. https://doi.org/10.1136/bmjophth-2019-000315\u003c/li\u003e\n\u003cli\u003eZhou Y, Murrough J, Yu Y, et al (2022) Association Between Depression and Severity of Dry Eye Symptoms, Signs, and Inflammatory Markers in the DREAM Study. JAMA Ophthalmol 140:392\u0026ndash;399. https://doi.org/10.1001/jamaophthalmol.2022.0140\u003c/li\u003e\n\u003cli\u003eCheung R, Yu B, Iordanous Y, Malvankar-Mehta MS (2021) The Prevalence of Occupational Burnout Among Ophthalmologists: A Systematic Review and Meta-Analysis. Psychol Rep 124:2139\u0026ndash;2154. https://doi.org/10.1177/0033294120954135\u003c/li\u003e\n\u003cli\u003ede Paiva CS (2017) Effects of Aging in Dry Eye. Int Ophthalmol Clin 57:47\u0026ndash;64. https://doi.org/10.1097/IIO.0000000000000170\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"inte","sideBox":"Learn more about [International Ophthalmology](https://www.springer.com/journal/10792)","snPcode":"10792","submissionUrl":"https://submission.nature.com/new-submission/10792/3","title":"International Ophthalmology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Dry eye disease, Cross-sectional study, DEQ-5 survey/questionnaire, prevalence, severity, United Arab Emirates","lastPublishedDoi":"10.21203/rs.3.rs-7500263/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7500263/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e\u003cp\u003eDry eye disease (DED) is a common ocular condition that, if left untreated, can lead to visual impairment. Several studies have reported the prevalence of DED among the general population. The present study was conducted to investigate the prevalence of DED among ophthalmologists and allied ocular care professionals.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003e This cross-sectional study included ophthalmologists and allied ocular care professionals who attended the Emirates Society of Ophthalmology (ESO) conference in 2024 in the United Arab Emirates. Eligible participants were asked to complete the Dry Eye Questionnaire (DEQ-5), based on which the presence and severity of DED were assessed.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe study included 203 participants (53.2% males), with the majority being ophthalmologists (47.8%), followed by nurses (17.2%), optometrists (13.8%), and others (21.2%). The overall prevalence of DED was 82.8%. It was significantly higher among females than males (88.4% vs 77.8%, p\u0026thinsp;=\u0026thinsp;0.0460), and female optometrists had a 4.36-fold higher risk of DED than male optometrists (p\u0026thinsp;=\u0026thinsp;0.0127). Regarding DED severity, 27.6% of the participants had mild DED, 35.5% had moderate DED, and 19.7% had severe DED. Females who worked as ophthalmologists (RR\u0026thinsp;=\u0026thinsp;1.72, p\u0026thinsp;=\u0026thinsp;0.0450) and those engaged in other professions (RR\u0026thinsp;=\u0026thinsp;3.31, p\u0026thinsp;=\u0026thinsp;0.0024) had a significantly higher risk of severe DED.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThis study highlights alarmingly high rates of DED among ophthalmologists and allied ocular care professionals. Female professionals, particularly those who work as optometrists, have a significantly higher risk of DED than their male counterparts.\u003c/p\u003e","manuscriptTitle":"Prevalence and severity of dry eye disease among ophthalmologists and allied ocular care professionals","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-20 13:48:24","doi":"10.21203/rs.3.rs-7500263/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-16T04:42:02+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-15T15:32:57+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-14T10:48:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"282463564911314071778364137971991337671","date":"2025-11-11T13:42:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"108695830603339307155122493135219648787","date":"2025-11-11T06:42:07+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-11T06:34:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"166062101834291173623986092599861978022","date":"2025-11-11T04:33:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"109792931259711368622423054428914917133","date":"2025-11-11T03:52:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"275074293597847285323179792979286719464","date":"2025-11-11T03:05:18+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-10T17:45:58+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-01T11:14:13+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-01T11:11:01+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Ophthalmology","date":"2025-08-31T11:24:35+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"inte","sideBox":"Learn more about [International Ophthalmology](https://www.springer.com/journal/10792)","snPcode":"10792","submissionUrl":"https://submission.nature.com/new-submission/10792/3","title":"International Ophthalmology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"daf3a40d-3778-45b9-be4a-c070081bafbc","owner":[],"postedDate":"November 20th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-02-23T16:04:57+00:00","versionOfRecord":{"articleIdentity":"rs-7500263","link":"https://doi.org/10.1007/s10792-026-03981-4","journal":{"identity":"international-ophthalmology","isVorOnly":false,"title":"International Ophthalmology"},"publishedOn":"2026-02-16 15:59:41","publishedOnDateReadable":"February 16th, 2026"},"versionCreatedAt":"2025-11-20 13:48:24","video":"","vorDoi":"10.1007/s10792-026-03981-4","vorDoiUrl":"https://doi.org/10.1007/s10792-026-03981-4","workflowStages":[]},"version":"v1","identity":"rs-7500263","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7500263","identity":"rs-7500263","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}