Association between dry eye symptoms and upper-eyelid position in Korean adults: A nationwide population-based study

BACKGROUND To investigate the association between dry eye symptoms and upper-eyelid position in a nationally representative Korean population. METHODS Data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2010 and 2012 were analysed to assess the relationship between upper-eyelid position and the presence of dry eye symptoms. In total, 11,385 subjects aged 40 years or older were included, and multiple logistic regression was performed to adjust for potential confounders. Sampling weights were applied to obtain estimates for the general Korean population. RESULTS Patients with dry eye symptoms were more likely to be women, non-smokers, and non-drinkers, and were more commonly residents of urban areas. They also had elevated marginal reflex distance 1 (MRD1) values and a higher prevalence of hypertension, depressive disorder, hyperlipidaemia, and thyroid diseases. An increase in MRD1 was significantly associated with higher odds of experiencing dry eye symptoms in both the right and left eyes ( P  = 0.0043 and P  = 0.0055, respectively). CONCLUSIONS Increased MRD1 was significantly associated with dry eye symptoms in a representative Korean population. These findings imply that dry eye symptoms can potentially worsen after upper-eyelid surgeries, including ptosis correction, and should be considered during preoperative evaluation and counselling.