Experience with ocular surface disease index analysis to assess dry eye disease and related conditions in Lagos, Nigeria.

INTRODUCTION: dry eye disease (DED) is a multifactorial ocular surface disorder that remains underdiagnosed, particularly in sub-Saharan Africa, where epidemiological data are limited. This study aimed to describe the distribution and severity of DED using the Ocular Surface Disease Index (OSDI), and to evaluate its association with demographic factors and objective diagnostic tests among adults in Lagos, Nigeria. METHODS: we conducted a hospital-based cross-sectional study involving 173 consecutive participants recruited from ophthalmology, rheumatology, and dental clinics in Lagos, Nigeria. Participants completed the OSDI questionnaire and underwent Schirmer´s test and Tear Break-Up Time (TBUT) assessment. Demographic and clinical variables were analysed using STATA version 16.1. The sensitivity, specificity, and predictive values of OSDI were evaluated against objective measures of ocular dryness. RESULTS: the mean OSDI score was 21.2 ± 18.9. Forty percent of participants had scores within the normal range, while 24.3% had severe DED. Higher OSDI scores were observed among females, older participants, and those with a prior diagnosis of dry eye or systemic dryness symptoms, although not all associations reached statistical significance. When compared with objective tests, OSDI demonstrated high sensitivity but low specificity (7-13%). CONCLUSION: dry eye disease is common among adults attending tertiary clinics in Lagos and presents with heterogeneous ocular and systemic features. While OSDI is a useful high-sensitivity screening tool, its low specificity underscores the need for confirmatory objective testing. Larger population-based studies are warranted to better define the epidemiology and determinants of DED in Nigeria.