Association of Severity of Dry Eye Disease with Work Productivity and Activity Impairment in the Dry Eye Assessment and Management Study

PURPOSE: To evaluate the association of dry eye disease (DED) severity with work productivity and activity impairment. DESIGN: Longitudinal observational study within a randomized clinical trial. PARTICIPANTS: People with moderate to severe dry eye disease who enrolled in the multicenter Dry Eye Assessment and Management (DREAM) study. METHODS: Participants completed the Work Productivity and Activity Impairment questionnaire at 0, 6, and 12 months and were assessed in parallel for symptoms and signs (conjunctival and corneal staining, tear break-up time, and Schirmer test) of DED. Associations of work productivity and activity impairment with symptom and signs were evaluated with linear regression models using generalized estimating equations and controlling for demographics and comorbidities. MAIN OUTCOME MEASURES: Work productivity (employment, absenteeism, presenteeism, overall work impairment) and activity impairment. RESULTS: Among 535 participants at baseline, 279 (52%) were employed and mean activity impairment was 24.5%. Among those employed, the mean score was 2% for absenteeism, 18% for presenteeism, and 19.6% for overall work impairment. Higher Ocular Surface Disease Index (OSDI) symptom scores were associated with greater absenteeism, presenteeism and activity impairment. Overall work impairment and activity impairment were greater by 4.3% and 4.8%, respectively, per 10 units difference in OSDI score (p