Purpose To investigate the association between dry eye disease and each of depression and anxiety. Design Retrospective, case-control study Methods Setting University of North Carolina outpatient clinics Study Population All patients over the age of 18 years old seen between July of 2008 and June of 2013 were included in the analysis. Observation Procedure Cases were defined according to ICD-9 diagnosis codes for dry eye disease, anxiety, and depression. Outcome Measure Separate odds ratios were calculated for dry eye disease and each of anxiety and depression. Similar odds ratios were also calculated between dry eye disease and rheumatoid arthritis, a systemic disease with a known association with dry eye, as a way of validating our approach. Results A total of 460,611 patients were screened; 7,207 patients with dry eye were included, while 20,004 patients with anxiety and 30,100 patients with depression were included. The adjusted odds ratio for dry eye disease and anxiety was 2.8 (95% CI 2.6–3.0). For dry eye disease and depression, the odds ratio was 2.9 (95% CI 2.7–3.1). Conclusions We identified a statistically significant association between dry eye disease and each of depression and anxiety. Such an association has implications for ophthalmologists in the management and treatment of dry eye disease.

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