Dry Eye Symptoms Among Adults Aged 40 Years and Older in Gaza During Humanitarian Crisis: Prevalence and Associated Factors.

BACKGROUND

Dry eye disease (DED) affects visual function and quality of life. In Gaza, conflict, displacement, environmental exposure, and psychological distress may increase risk, but evidence is limited. This study estimated DED symptom prevalence among adults aged ≥40 years and examined associated factors.

METHODS

A community-based cross-sectional convenience sample of 296 adults aged ≥40 years living in houses, shelters, or tents in Gaza was surveyed face-to-face. Arabic OSDI assessed symptoms (≥13) and severe symptoms (≥33). Psychological distress was measured using the Arabic DASS-8. Exploratory analyses examined continuous OSDI scores, housing type, geographic/displacement context, and the OSDI environmental-trigger domain. Adjusted associations were evaluated using regression models with robust standard errors.

RESULTS

Overall, 97.3% of participants had DED symptoms. Living in tents (PR 1.05, 95% CI 1.01-1.10; P = 0.024) and age ≥70 years (PR 1.05, 95% CI 1.00-1.09; P = 0.028) were associated with slightly higher prevalence. Higher DASS-8 scores were associated with greater continuous OSDI scores and more severe symptoms. Participants in the South/displaced group had greater symptom burden than those surveyed in the North.

CONCLUSION

DED symptoms were nearly universal in this convenience sample. Greater symptom burden was associated with psychological distress and displacement context, although specific environmental exposures were not measured directly.