The burden of keratoconjunctivitis sicca in Nigeria: a scoping review of prevalence and risk factors.

BACKGROUND

Keratoconjunctivitis sicca, commonly known as Dry Eye Disease (DED), is a multifactorial disorder of the ocular surface characterised by tear film instability, ocular discomfort, and visual disturbance. The burden of DED has increased globally and is associated with several environmental, demographic, and ocular risk factors. Despite its growing public health importance, a comprehensive, nationally representative estimate of the prevalence and risk factors of DED in Nigeria is lacking, with existing evidence characterised by significant heterogeneity in study design, diagnostic criteria, and regional coverage. This scoping review summarises the available evidence on DED and its public health significance in Nigeria, maps knowledge gaps, and identifies areas for future research.

METHODOLOGY: A comprehensive search was conducted across PubMed, Google Scholar, ScienceDirect, African Journals Online (AJOL), and grey literature for studies published within the past 18 years. Eligible studies investigated keratoconjunctivitis sicca or dry eye disease (DED) among human populations in Nigeria. Data were synthesised thematically in a narrative form. Eligible studies investigated keratoconjunctivitis sicca or dry eye disease (DED) among human populations in Nigeria. Data were synthesised thematically in a narrative form.

RESULTS

Thirteen studies (n = 4,217) conducted in Nigeria that met the inclusion criteria were included. Various study designs, including cross-sectional, longitudinal, and case-control, were represented. Across studies, the prevalence rates among adults were high, with more than a quarter of the population affected, the highest being in Oyo State. The highest clinical prevalence was observed in studies focusing on specific co-morbidities, such as 58.2% in non-diabetics in a Lagos hospital and 76% among diabetic patients in Kaduna State. Regarding demographic factors, age, gender, and educational level were identified as risk factors for DED.

CONCLUSION

Keratoconjunctivitis sicca represents a significant but often under-recognised ocular health burden in Nigeria, particularly affecting older adults, females, and individuals with systemic and environmental risk factors. DED may also contribute to visual impairment both as a primary condition and as a comorbidity. Effective prevention and management necessitate strengthening awareness, improving screening in clinical and community settings, and expanding research across underserved regions.