Analysis assesses relationship between dry eye and psychiatric disorders
A meta-analysis found that depression and anxiety are significantly correlated with dry eye symptoms, but not with dry eye signs.
Depression and anxiety are more common and more severe in dry eye patients, according to a review and meta-analysis published in the July 2022 issue of European Journal of Ophthalmology.
“The relationship between dry eye and psychiatric disorders is complex. Although a strong association has repeatedly been found between these disorders, the interaction between them is still unclear,” the researchers wrote.
Dry eye is a common inflammatory disease that is estimated to affect 39 million or more adults in the United States. The disease can lead to dryness, inflammation, pain, discomfort, irritation, reduced quality of life and, in severe cases, permanent visual impairment.
The investigators, led by Monali S. Malvankar-Mehta, Ph.D., assistant professor at the Schulich School of Medicine and Dentistry, Western University, in Ontario, Canada, conducted a literature review to assess correlations between depression and Anxiety with Dry Eye Signs and Symptoms. They included 32 studies in their review, including 31 on depression and 19 on anxiety, published between 2015 and 2019. Most of the studies used self-report questionnaires, the most common being the Patient Health Questionnaire and the Hospital Anxiety and Depression Scale (HADS). ). Three studies used clinical diagnosis to determine depression status.
This analysis confirmed the association of dry eye and depression and anxiety. The meta-analysis revealed a prevalence of depression of 40% in patients with dry eye. The prevalence of anxiety was 39%. Depression and anxiety scores were significantly higher in dry eye patients in all studies reviewed.
A previous systematic review of studies published before 2015 found similar results, with the risks of depression and anxiety being 2.92 and 2.80 times higher, respectively, in DED patients.
In this analysis, depression and anxiety were found to be significantly correlated with dry eye symptoms, but not with dry eye signs.
“It is likely that depression and anxiety can be causes as well as effects of DED. The eye discomfort and eye strain of DED can be distressing to patients, limit functioning and lead to mood changes” , they wrote.
One of the limitations of this review was that it included all types of dry eye etiology, which resulted in significant heterogeneity of included studies. This may have limited the generalizability of the results. In addition, most of the studies reviewed used self-report questionnaires and the studies used several different scales.