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There is increasing recognition of dry eye disease (DED) as a significant factor influencing quality of life in seemingly normal individuals. Our goal was to determine the distribution of Ocular Surface Disease Index (OSDI) scores in non-clinical individuals in Karachi, Pakistan.  Methods  We distributed OSDI questionnaires to subjects aged > 18 years with no active ocular complaint. Examiners were selected from various areas of the city to administer questionnaires to students and the general population. The OSDI score was grouped as per the following: normal (0-12 points), mild (13-22 points), moderate (23-32 points), and severe (33-100 points).  Results  We surveyed 2433 individuals with a mean age of 30.7±15.6 years. Additionally, the mean OSDI score was 22.4±18.7. To estimate prevalence, we used two OSDI score cutoffs: >13 (64.4%) and >22 points (43.6%). Statistical significance was found using multivariate regression in the following variables: age (p<0.001), contact lens wear (p<0.001), ocular allergies (p<0.001), hypertension (p<0.001), diabetes (p=0.003), and smoking (p=0.047). When graphing mean age against OSDI score, there was a large jump between the third and fourth decades; thereafter, there was a steady increase. Similarly, when plotting smoking, the score was steady until five years and then there was a sharp incline.  Conclusion  There was a high prevalence of DED in the studied population. Additionally, many systemic and ocular factors were associated with this disease.

Distribution and Correlation of Ocular Surface Disease Index Scores in a Non-Clinical Population: The Karachi Ocular Surface Disease Study