Smartphone app helps identify symptomatic dry eye risk factors
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A smartphone app’s crowdfunded research helped identify dry eye and its risk factors, according to a study.
The DryEyeRhythm app, available in Japan and the United States on iOS platforms, collects demographic characteristics, medical history and lifestyle information, as well as daily subjective dry eye symptoms.
This cross-sectional study used data from 4,454 subjects in Japan, 3,294 with risk factors for symptomatic dry eye and 1,160 without symptomatic dry eye; of the 3,294 with risk factors, 899 had diagnosed symptomatic dry eye and 2,395 had undiagnosed symptomatic dry eye. Dry eye symptoms and severity were assessed with a 12-item Ocular Surface Disease Index questionnaire.
Those with symptomatic dry eye were younger, mostly female individuals with a history of pollinosis. Extended screen exposure, contact lens use, smoking, and mental illnesses other than depression or schizophrenia were also identified as risk factors.
“This study may lead to further understanding of dry eye symptoms and identify at-risk individuals who should be clinically evaluated, potentially improving prevention or early treatment of dry eye disease,” the study authors wrote.
The use of a smartphone app to identify and understand disease is relatively new, but this study could assist in future developments.
“Mobile health technologies could be used for the detection and management of chronic disease as well as for research to advance our understanding of dry eye disease,” the authors wrote.
Adherence rate, which is important in designing research applications, was 45.8%, with 4,454 of 9,729 users participating.
“Developing a user-friendly interface, linking interactive voluntary posting functions to social media, offering feedback functions and other incentives might help to improve study adherence and completion,” the study said. – by Rebecca L. Forand
Disclosures: Inomata reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
Perspective
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Darrell E. White, MD
DryEyeRhythm is an iPhone app that surveys users about lifestyle, health history and dry eye symptoms. The app is reporting primarily on “digital natives”; only 2% of respondents were “digital immigrants,” those older than 60. Not surprisingly, the results confirm that increased digital screen time is associated with a greater prevalence and severity of dry eye symptoms.
However, this younger cohort does differ in significant ways from other older groups. For example, various chronic illnesses that we routinely associate with dry eye symptoms such as diabetes and hypertension do not appear to be factors in younger patients. On the other hand, sex does seem to be a universal risk factor; even in the young, dry eye is much more common in women. While the disease and symptoms are the same in both groups, they do appear to arrive there via different routes.
This sort of crowdsourcing research is fascinating. Both researchers and front-line caregivers can acquire information from very large groups. With the addition of “big data” analysis, we can see patterns that would evade discovery even in the largest, busiest clinical settings. We should temper our enthusiasm with the caveat that this is still a self-reported symptom survey with all of the well-known risks for overreporting inherent in such studies. The addition of high tech does not remove this bias.
Finally, I would be remiss if I did not at least mention the irony at play in this study: Respondents are using their phones to report on symptoms that are caused by a disease that results from using their phones.
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