Vehof, Jelle, Snieder, Harold, Jansonius, Nomdo et al. · The ocular surface · 2021 · DOI
This large study of nearly 80,000 Dutch adults found that about 9 out of 100 people experience dry eye symptoms. Interestingly, younger adults (ages 20-30) reported dry eye more often than expected. The researchers discovered that dry eye is connected to many different health conditions, including fibromyalgia, chronic fatigue syndrome, depression, and various autoimmune diseases.
ME/CFS patients frequently report dry eye and related ocular symptoms as part of their disease burden. This large study's identification of strong associations between chronic fatigue syndrome and dry eye, along with overlapping comorbidities (fibromyalgia, autoimmune conditions, sleep apnea), suggests shared underlying mechanisms worth investigating. Understanding these connections may help identify pathophysiological pathways relevant to ME/CFS.
This study demonstrates statistical association, not causation—dry eye and conditions like ME/CFS could share common causes rather than one causing the other. The cross-sectional design captures only a snapshot in time and cannot establish temporal sequence. Self-reported symptoms without clinical validation may overestimate or underestimate true dry eye disease prevalence.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Vehof, Jelle, Snieder, Harold, Jansonius, Nomdo, & Hammond, Christopher J (2021). Prevalence and risk factors of dry eye in 79,866 participants of the population-based Lifelines cohort study in the Netherlands.. The ocular surface. https://doi.org/10.1016/j.jtos.2020.04.005
BibTeX
@article{mecfsatlas-vehof-2021-prevalence-risk,
author = {Vehof, Jelle and Snieder, Harold and Jansonius, Nomdo and Hammond, Christopher J},
title = {Prevalence and risk factors of dry eye in 79,866 participants of the population-based Lifelines cohort study in the Netherlands.},
journal = {The ocular surface},
year = {2021},
doi = {10.1016/j.jtos.2020.04.005},
note = {PubMed: 32376389},
url = {https://www.mecfsatlas.com/evidence/vehof-2021-prevalence-risk},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/vehof-2021-prevalence-risk
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