@article {1573117,
	title = {Heterogeneity of eye drop use among symptomatic dry eye individuals in Japan: large-scale crowdsourced research using DryEyeRhythm application},
	journal = {Jpn J Ophthalmol},
	volume = {65},
	number = {2},
	year = {2021},
	month = {2021 Mar},
	pages = {271-281},
	abstract = {PURPOSE: To determine eye drop type and usage frequency and investigate risk factors for no eye drop use in individuals with symptomatic dry eye (DE) in Japan. STUDY DESIGN: Crowdsourced observational study. METHODS: This study was conducted using the DryEyeRhythm smartphone application between November 2016 and September 2019. Data collected included the type and frequency of eye drop use, demographics, medical history, lifestyle, and self-reported symptoms. Symptomatic DE was defined as an Ocular Surface Disease Index total score of >= 13. Risk factors for no eye drop use were identified using multivariate logistic regression analyses. RESULTS: Among 2619 individuals with symptomatic DE, 1876 did not use eye drops. The most common eye drop type was artificial tears (53.4\%), followed by hyaluronic acid 0.1\% (33.1\%) and diquafosol sodium 3\% (18.7\%). Risk factors (odds ratio [95\% confidence interval]) for no eye drop use were age (0.97 [0.97-0.98]), body mass index (1.04 [1.01-1.07]), brain disease (0.38 [0.15-0.98]), collagen disease (0.30 [0.13-0.68]), mental illness other than depression and schizophrenia (0.65 [0.45-0.93]), cataract surgery (0.12 [0.02-0.59]), ophthalmic surgery other than cataract and laser-assisted in situ keratomileusis (0.55 [0.34-0.88]), current (0.47 [0.38-0.57]) or past (0.58 [0.43-0.77]) contact lens use, \&gt;8\&nbsp;h screen exposure time (1.38 [1.05-1.81]), \&lt;6\&nbsp;h (1.24 [1.01-1.52]) and \&gt;9\&nbsp;h (1.34 [1.04-1.72]) sleep time, and water intake (0.97 [0.94-0.98]). CONCLUSION: Many participants with symptomatic DE did not use optimized eye drop treatment and identified risk factors for no eye drop use. The DryEyeRhythm application may help improve DE treatment.},
	issn = {1613-2246},
	doi = {10.1007/s10384-020-00798-1},
	author = {Eguchi, Atsuko and Inomata, Takenori and Nakamura, Masahiro and Nagino, Ken and Iwagami, Masao and Sung, Jaemyoung and Midorikawa-Inomata, Akie and Okumura, Yuichi and Fujio, Kenta and Fujimoto, Keiichi and Miura, Maria and Akasaki, Yasutsugu and Shokirova, Hurramhon and Hirosawa, Kunihiko and Kuwahara, Mizu and Zhu, Jun and Dana, Reza and Murakami, Akira and Kobayashi, Hiroyuki}
}
