The Association Between Dry Eye Disease and Depression and Anxiety in a Large Population-Based Study

Abstract

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.

Dry Eye-Related Visual Blurring and Irritative Symptoms and Their Association with Depression and Anxiety in Eye Clinic Patients

“…Recently, DES has been linked to psychological distress in a large population-based retrospective study. 27 However, it is not clear from previous studies, which symptoms and signs of dry eye are associated with signs of psychological distress. These associations, if known, may have implications in the management of psychological distress among dry eye patients and provide insight into the relationship between dry eye and psychological syndromes.…”

Depression, Stress, Quality of Life, and Dry Eye Disease in Korean Women

“…Very recently, one large population-based study of all age groups also identified a statistically significant association between DED and each of depression and anxiety. 18 The purpose of this study was to determine the prevalence of depression in patients with DED and the nature of the relationship between depression and DED in Korean women. The Korea National Health and Nutrition Examination Survey (KNHANES) enables the examination of extensive data on health and socioeconomic status using a large population in Korea.…”

Symptoms of Dry Eye Disease and Personality Traits

“…However, if this was the case, then eye care practitioners would never be able to explain the cause of these symptoms by simply using standard ophthalmic examinations. In fact, some investigators have reported finding a significant relationship between a patient's symptoms and their psychogenic status, such as depression, anxiety, or a subjective happiness feeling [5–11, 18], which suggests these relationships may need to be taken into consideration. In addition, sensitivity to pain has been reported to play a significant role in the severity of the DED complaints [12, 13], which also suggests importance of the non-ocular status of the patients with the DED symptoms.…”

“…As a result, there has been little reported on any associations between the DED signs and symptoms [2–4]. On the other hand, multiple studies have examined the effects of the psychological influences including depression, anxiety, or feelings of subjective happiness on the subjective symptoms, and have reported finding a positive correlation [5–11]. In addition, pain sensitivity may also play a role in the DED symptoms.…”