Prevalence, Clinical Subtypes, and Associated Factors of Dry Eye Disease Among Pregnant Women in Dar es Salaam, Tanzania.

Background Dry eye disease (DED) is a multifactorial condition marked by tear film instability and ocular inflammation, causing symptoms like grittiness and blurred vision. The global prevalence of Dry eye disease among pregnant women ranges from 27.4% to 89.3% and in Africa it ranges between 20% and 50%. Hormonal changes, advanced maternal age, late pregnancy and prolonged screen time play an important part in its development. Methodology A hospital-based cross-sectional study among 380 pregnant women. Systematic sampling technique was used for recruitment at the antenatal clinic in Mnazi Mmoja Hospital in Dar es Salaam. Clinical dry eye tests were performed along with the administration of a symptom questionnaire that included demographic characteristics and the OSDI tool where OSDI >13 is the threshold for diagnosis of DED. Data were analyzed using Stata version 17.0 and Modified Poisson analyses identified factors associated with dry eye disease, with statistical significance set at p-value<0.05. Results A total of 380 pregnant women were recruited and analyzed with the mean age 31.7{+/-}6.7, 196 (51.6%) were aged 31-46 years. Most were married 273 (71.8%) and 211 (55.5%) had completed secondary education. Dry eye disease (DED) prevalence was 53.2% (48.8%-58.2%). Among those with DED (n=202), 112 (55%) had mild symptoms, 26 (13%) moderate, and 64 (32%) severe. The most common DED subtype was unclassified 72 (35.6%), followed by mixed (67, 33.2%), evaporative 50 (24.8%), and aqueous deficient 13 (6.4%). Significant associations with DED were: advanced gestation age (aPR=2.18 (1.550-3.072), p<0.001), being a housewife (aPR=1.48(1.179-1.857), p=0.001), use of visual display terminals (aPR=1.36(1.219-1.845), p=0.048), working in low humidity (aPR=2.62(1.698-4.045), p=0.001), and working in air-conditioned rooms (aPR=2.40(1.685-3.415), p=0.001). Secondary education was protective against DED (aPR = 0.668 (0.466-0.958), p = 0.028). Conclusion Approximately half of pregnant women have DED, with unclassified DED being the predominant subtype. Late gestation age, occupation, extended screen time, and working environment are significantly associated factors. It is essential to integrate DED screening into antenatal care and establish standardized protocols on DED management. Also, it is essential to promote lifestyle modifications such as reduction of screen time and avoiding dry environments.