Skip to main content

  • Depression and Severity of Dry Eye Signs and Symptoms

    By Jean Shaw
    Selected and reviewed by Neil M. Bressler, MD, and Deputy Editors
    Add to My Bookmarks

    Journal Highlights

    JAMA Ophthalmology, April 2022

    Download PDF

    Zhou et al. investigated the association between depression and severity of dry eye disease (DED). They found that pa­tients with depression had worse DED symptoms and more ocular discomfort than did those without depression.

    For this cross-sectional study, the researchers performed a secondary analysis of data from the DREAM (Dry Eye Assessment and Management) study, which evaluated the efficacy of omega-3 fatty acid supplements for DED. The Ocular Surface Disease Index (OSDI) and Brief Ocular Discomfort Index (BODI) were used to assess DED symptoms. DED signs were assessed by tear film breakup time, Schirmer test, corneal and conjunctival staining, tear osmolarity, and meibomian gland dys­function at baseline, six months, and 12 months, and a composite score was calculated. DED features were com­pared for participants with and without depression and adjusted for age, sex, race, visits, and baseline comorbidities. Markers of inflammation (e.g., proin­flammatory cytokines) were measured for some trial participants. The Mental Component Summary (MCS) score of the 36-Item Short Form Health Survey was used to screen for depression.

    The majority of the 535 participants were women (n = 434, 81%) and White (n = 398, 74.4%). All were age 18 years or older (mean, 58 years). A total of 84 participants (15.7%) had depression at baseline, compared to 82 at six months and 64 at 12 months.

    Those who screened positive for depression had worse DED symptoms by OSDI (effect size = .45; p < .001), BODI (effect size = .46; p < .001), and composite DED sign score (effect size = .21; p = .006). A lower MCS score (which signifies a higher level of de­pression) was correlated with a higher OSDI score at baseline and at the six-and 12-month marks. Inflammatory markers did not differ by depression status.

    The findings support consideration of depression as a comorbidity when managing patients with DED, the au­thors said. (Also see related commentary by Anat Galor, MD, MSPH, in the same issue.)

    The original article can be found here.