Dry eye symptoms in midlife women: A cross-sectional analysis of prevalence, risk factors, and quality-of-life outcomes

Objectives: To assess the prevalence, associated factors, and quality-of-life impact of dry eye symptoms among perimenopausal and postmenopausal women in Thailand. Study Design: This cross-sectional study, conducted from September to December 2024, included 262 women aged 41–60 years attending a gynaecology and menopause clinic at Ramathibodi Hospital. Participants completed the Ocular Surface Disease Index and the Menopause-Specific Quality of Life questionnaires. Multivariate logistic regression was used to identify factors associated with moderate to severe symptoms. Main outcome measures: The primary outcome was the prevalence of dry eye symptoms. Secondary outcomes included symptom severity, quality-of-life scores, and occupational or clinical risk factors for moderate to severe symptoms. Results: Dry eye symptoms were identified in 64.9 % of participants, with comparable rates in perimenopausal (61.7 %) and postmenopausal (68.2 %) women. No significant difference in symptom scores was observed between groups (p = 0.746). Computer-based work was independently associated with moderate to severe symptoms (adjusted odds ratio 1.81, 95 % CI 1.10–2.99). Women with more severe symptoms reported significantly poorer physical, psychological, and vasomotor quality-of-life scores. Conclusions: Dry eye symptoms are highly prevalent among midlife Thai women and negatively affect quality of life, particularly in the physical, psychological, and vasomotor domains. Occupational screen exposure is a significant modifiable risk factor. Early screening and targeted management may help reduce the impact of symptoms during the menopausal transition.