Outcomes of a survey of dry eye disease amongst cigarette smokers in a peripheral medical college

Abstract

To find out an association, if any, between smoking and dry eye diseases and whether it has any relation to the number of cigarettes smoked. Patients attending the hospital outpatient department were enquired about smoking and then given the option to enrol in the study following a written and informed consent. Depending on the number of cigarettes they smoked, patients were divided in three groups, namely low, moderate and high smokers based on the heaviness of Smoking Index. They were labelled as Group A, B and C respectively. Symptomatic assessment of each group was done by the Ocular Surface Disease Index (OSDI) questionnaire, and a score greater than 12 was considered meaningful. Clinical evaluation was done by performing TBUT and Schirmer’s test. Respective cut off values were 10 seconds and 10 mm. Deviations from established normal values were observed and analyzed. A total of 205 patients participated in this study of which 90.7% (n= 186) were males and 9.3% (n= 19) were females. 30.7% (n= 63) patients were low smokers (Group A), 42.9% (n= 88) were moderate smokers (Group B) and 26.3% (n= 54) were high smokers (Group C). The mean TBUT and OSDI scores showed progressive deterioration from Group A to C, whereas the mean Schirmer’s values across all groups remained relatively unaffected. Cigarette smoking had a deleterious effect on the health of the ocular surface, but the aqueous tear secretion remained unaffected.