Global prevalence of dry Eye: A systematic review and meta-analysis

Dry eye significantly impacts global quality of life and productivity, yet existing epidemiological data remain fragmented and outdated, hindering effective prevention and management strategies. This study aimed to estimate the global prevalence of dry eye and examine variations across regions, demographics, diagnostic criteria, study settings, and the COVID-19 pandemic.

A systematic search of PubMed, Web of Science, Embase, and Cochrane Library identified 119 cohort or cross-sectional studies involving 15,251,528 participants. Two reviewers independently screened records, extracted data, and assessed study quality using the Joanna Briggs Institute checklist. A random-effects model pooled prevalence estimates, with subgroup analyses exploring heterogeneity.

The global pooled prevalence of dry eye was 34.6% (95% CI: 30.2%-39.4%). Regional disparities were pronounced, with the highest prevalence in Africa 43.9% (95% CI: 31.5%-57.2%) and the lowest in North America 20.9% (95% CI: 8.2%-43.8%). Higher rates were observed in females 39.1% (95% CI: 32.8%-45.8%) vs. males 30.8% (95% CI: 24.8%-37.7%), individuals aged > 40 years 37.0% (95% CI: 29.1%-45.7%) vs. ≤ 40 years 35.0% (95% CI: 25.4%-46.0%), institutional settings 45.2% (95% CI: 36.2%-54.5%), and during COVID-19 44.5% (95% CI: 28.0%-62.2%). Diagnostic criteria significantly influenced estimates, ranging from 6.9% (95% CI: 1.9%-21.7%) (ICD-9-based) to 53.8% (95% CI: 46.7%-60.8%) (OSDI ≥ 13).

Dry eye represents a major global public health challenge, with prevalence shaped by geographic, demographic, environmental, and methodological factors. The pandemic exacerbated dry eye burden, underscoring the urgency for standardized diagnostic protocols and targeted interventions to mitigate its growing impact.