Keratoconjunctivitis sicca in a Tertiary Hospital in Lagos Nigeria

Abstract

Background: Keratoconjunctivitis sicca is a growing public health problem and a common cause of ocular morbidity, which is often  unrecognized by eye care practitioners. It is also a cause of visual impairment and ocular discomfort. Recent changes in global climate may have contributed to the increased incidence and severity of the disease

Objective: To determine the prevalence and identify risk factors for Keratoconjunctivitis sicca (KCS) in patients presenting at a tertiary ophthalmic center.

Methods: The study was a cross-sectional descriptive hospital-based survey conducted at the Guinness Eye Centre of the Lagos  University Teaching Hospital (LUTH) between a one year period of November 2015 and October 2016. A total population sampling method was used. All new patients 16 years and above, that presented to the Eye Clinic during the study period who met the inclusion criteria and gave consent were included in the study. The participant's socio-demographic data were obtained and Keratoconjunctivitis Sicca was assessed using the Ocular Surface Disease Index (OSDI), Shirmer's Test and Tear Film Break Up Time (TFBUT). An OSDI score of ≥50 with a TFBUT of <10 seconds or Shirmer's Test reading of <10mm was considered diagnostic of KCS. In all data analysis and comparisons, a p value <0.05 was considered statistically significant.

Results: A total of 300 eyes in 150 patients comprising 65 males and 85 females were analyzed. The average age was 47.4 ± 18.2 years and age range was 16-84 years. The prevalence of KCS was 54.3%. KCS was significantly associated with increasing age with a mean age of 50.3 years (p value= 0.031). The prevalence of KCS increased per decade of life and was seen in 72.2% of patients above the age of 70 years, was seen more in the female gender (prevalence of 56.5%), use of computer screen based technologies (55.7%) and cigarette smoking (odds ratio of 3.53). The positive predictive value of the OSDI was 53.2%.

Conclusion: The prevalence of Keratoconjunctivitis Sicca is high especially in our evolving technological world today. There should be a high index of suspicion in patients who fit into the demographic of individuals with KCS. Therefore, screening should be done for such patients with the risk factors irrespective of their symptoms so that appropriate care may be rendered.

Keywords: Keratoconjunctivitis Sicca, prevalence, risk factors