The most common issues patients had in their daily lives were the need to wear sunglasses, the need to avoid air conditioning and trouble reading books.

Dry eye disease can be difficult to diagnose, and delays in diagnosis may lead to more severe symptoms and a greater impact on patients’ daily lives, according to a European study.

People with a delayed diagnosis were likely to have a more negative view of the condition and experience troubles in their work life, too, the researchers report in a paper online December 21 in the British Journal of Ophthalmology.

Marc Labetoulle of Bicetre Hospital in Le Kremlin-Bicetre Cedex, France and colleagues conducted an online survey of 706 patients with dry eye disease from France, Germany, Italy, Spain, and the UK.

All patients were over 40, did not wear contact lenses, and had used tear substitutes every day for the last six months.

Participants answered questions about their disease history and diagnosis, the relief treatments they used, their view of their condition, and its impact on their quality of life.

More than 40 percent were not diagnosed when their symptoms began. Just over a quarter - 28 percent - were diagnosed within one year of the start of their symptoms.

More than a third of patients visited more than one doctor before getting a diagnosis of dry eye disease.

Nearly a third perceived dry eye disease as a “disease” or even a “handicap”, while two thirds viewed the condition as just a “discomfort”.

Dry eye disease is a disorder that you are not cured of completely, so early diagnosis and management are important

The most common issues patients had in their daily lives were the need to wear sunglasses, the need to avoid air conditioning and trouble reading books.

Patients also reported having trouble using screens at work and in free time and being awakened at night by their symptoms.

People who used relief treatments three or more times a day were more likely than other patients to report that dry eye disease impacted their quality of life.

Dry eye disease patients who were diagnosed later were more likely to report daily discomfort and pain. Later diagnosis was also linked to a greater impact on patients’ overall quality life and work life specifically.

Dry eye disease can be difficult to diagnose because the symptoms can vary and often overlap with other eye disorders, said Dr Masakazu Yamada, a professor of ophthalmology at the Kyorin University School of Medicine in Tokyo, Japan, who was not involved in the study.

Dry eye disease “is a disorder that you are not cured of completely,’ Yamada said by e-mail. “Therefore, early diagnosis and management are important.”

“The first step (in) diagnosis is the awareness of symptoms,” Yamada said, adding that doctors need to understand these symptoms better as well to avoid delayed diagnosis.

The authors did not respond to a request for comment.