Association of Asthma with Dry Eye Disease Signs and Symptoms in the Dry Eye Assessment and Management (DREAM) Study

Purpose Recent literature has connected asthma with an increased risk of dry eye disease (DED). This study aimed to investigate the association of asthma and asthma medication with the severity of DED symptoms and signs.Methods This is a secondary analysis of data from the Dry Eye Assessment and Management (DREAM) study. At baseline and follow-up at 6 and 12 months, DED symptoms were measured using the Ocular Surface Disease Index (OSDI) and Brief Ocular Discomfort Index (BODI), and DED signs were measured using tear film breakup time (TBUT), corneal and conjunctival staining, Shirmer’s test, meibomian gland dysfunction testing, and tear osmolarity. DED symptoms and signs were compared between participants with self-reported ongoing asthma (n = 50) vs. those without a history of asthma (n = 470), and between participants taking (n = 88) vs. not taking (n = 432) asthma medications using multivariate analysis adjusted by factors previously reported to be associated with DED severity.Results In multivariate analysis, participants with ongoing asthma exhibited significantly shorter TBUT than those without asthma history (2.98 vs. 3.51 seconds, p = 0.01), but there were no significant differences in symptom scores (OSDI, BODI) and other DED signs. Asthma medication use was associated with more severe DED signs including TBUT (2.79 vs. 3.20 seconds, p = 0.03) and corneal staining score (4.40 vs. 3.68, p = 0.04).Conclusion These findings highlight the potential impact of asthma and asthma medication on DED severity. Further research is needed to investigate the underlying mechanisms and entertain personalized management strategies for DED in asthmatic populations.