Inflammatory bowel disease and the associated risk of dry eye and ocular surface injury: a nationwide matched cohort study

Yi Ting Ko, Yu Ming Wu, Hsiang Ling Wu, Shih Chung Lai, Ying Xiu Dai, Tzeng Ji Chen, Yih Giun Cherng, Ying Hsuan Tai, Chia Yu Kao

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Background: Inflammatory bowel disease (IBD) is associated with lacrimal gland dysfunction and ocular inflammation. The objective of this research was to elucidate the temporal relationships between IBD, dry eye disease (DED), and corneal surface damage. Methods: In a matched nationwide cohort study, we evaluated the risk of DED and corneal surface damage associated with IBD. Multivariable Cox proportional hazards regression analyses were implemented to estimate the risk of ocular complications. Results: A total of 54,293 matched pairs were included for analyses. The median follow-up time was 8.3 years (interquartile range: 5.5 – 10.5). The period incidence of DED was 8.18 and 5.42 per 1000 person-years in the IBD and non-IBD groups, respectively. After adjusting for confounders, statistically significant associations were found between IBD and DED [adjusted hazard ratio (aHR): 1.43, 95% confidence interval (CI): 1.35 – 1.51, p < 0.0001], Sjögren’s syndrome-related (aHR: 1.67, 95% CI:1.46 – 1.90, p < 0.0001) and non-Sjögren’s syndrome-related subtypes (aHR: 1.38, 95% CI: 1.30 – 1.46, p < 0.0001). Furthermore, increased risks of corneal surface damage (aHR: 1.13, 95% CI: 1.03 – 1.24, p = 0.0094) among the patients with IBD were observed when compared with the controls. Other independent factors associated with corneal surface damage were age (aHR: 1.003), sex (male vs. female, aHR: 0.85), and monthly insurance premium (501–800 vs. 0–500 U.S. dollars, aHR: 1.45; ≥ 801 vs. 0–500 U.S. dollars, aHR: 1.32). Conclusions: Our results suggested that IBD was an independent risk factor for DED and ocular surface damage. Clinical strategies are needed to prevent visual impairment or losses in these susceptible patients.

Original languageEnglish
Article number415
JournalBMC Ophthalmology
Issue number1
Publication statusPublished - Dec 2023


  • Crohn's disease
  • Keratoconjunctivitis sicca
  • Peripheral ulcerative keratitis
  • Ulcerative colitis

ASJC Scopus subject areas

  • Ophthalmology


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