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    Cornea/External Disease

    This study evaluated the overall prevalence, annual prevalence and incidence of dry eye disease (DED) in a large, representative population in the United States.

    Study design

    This retrospective analysis examined nearly 10 million beneficiaries in the Military Health System between 2003 and 2015. The authors performed an algorithmic evaluation of medical diagnosis codes and drug prescription patterns to determine the overall and annual prevalence, along with the annual incidence, of DED.


    The overall prevalence of DED was 5.28%, and increased with age. The overall prevalence was 7.78% for females and 2.96% for males, with the ratio remaining at 2:1 to 3:1 across all age groups. Annual prevalence increased over time, from 0.83% in 2005 to 3.02% in 2012. Similarly, the annual incidence rate increased from 0.55% in 2008 to 0.87% in 2012.


    This study is limited by its retrospective nature. In addition, the algorithmic approach to identifying DED patients could have introduced errors in identifying actual patients with this condition. While the study was restricted to military members and their dependents, the study did include all age groups. Likewise, the increasing trends in prevalence and incidence does not distinguish between actual increased disease or simply increased awareness and diagnosis.

    Clinical significance

    The study confirms the current prevalence and incidence of DED in a large cohort across the entire United States, including all age groups. The findings suggest that nearly 16 million Americans are affected by DED, and that these numbers are increasing. This further highlights the need for further investigation into the causes and treatments of DED.