Self-reported eye symptoms and related diagnostic findings--comparison of risk factor profiles

Profiles of factors affecting self-reported eye symptoms and objectively determined tear film characteristics have been examined and compared using data from 814 office workers. Multiple logistic regression analysis reveals significantly increased risks of subjective perception of eye symptoms for female gender, use of contact lenses and persons with health problems. A reduced break-up time (BUT) depends on personal criteria such as a history of eye disease and female gender. Age under 40 years, high relative humidity and formaldehyde exposure exceeding the 90th percentile are protective regarding BUT. For a thin lipid layer (as an indication of dry eyes) significantly increased risks are detected for high particle load, high endotoxin concentration and female gender. A thick lipid layer (as an indication of inflamed eyes) is significantly associated with a low educational level. The estimation of foam in the medial eye canthus seems to be unsuitable for evaluating indoor problems. The risk factor profiles agree on a few points only. The objectively examined thin lipid layer is the best eye-related indicator of the indoor environment. We therefore conclude that there is a need for the development and application of objective clinical methods for field monitoring in parallel with questioning.

Self-reported eye symptoms in conjunction with indoor environmental problems should be validated by objective medical examinations such as semi-quantitative estimation of the superficial lipid layer, measurement of the break-up time or assessment of conjunctival epithelial damage. For unbiased proof of environmental impact, personal factors such as acute illness or low job satisfaction should be excluded. As a minimum requirement, measurements of particles, NO(2) and relative humidity (and if possible endotoxin) should be carried out to detect any indoor environmental reason for eye symptoms.