A multicenter study published in JAMA Ophthalmology stated that patients with dry eyes and concomitant depression experienced more severe eye symptoms and clinical signs.

This was a secondary analysis of data from the Dry Eye Assessment and Management (DREAM) study, a randomized clinical trial which included 535 participants with a mean (SD) age of 58 (13.2) years. Symptoms of DED were assessed using Ocular Surface Disease Index (OSDI) and Brief Ocular Discomfort Index (BODI) and signs were assessed by tear film breakup time, Schirmer test, tear osmolarity, corneal and conjunctival staining, and meibomian gland dysfunction, at study initiation, and at 6 months and 12 months.

Based on Mental Component Summary (MCS) scores, 15.7% of the patients had depression at baseline, 17.3% at 6 months, and 13.2% at 12 months. It was observed that participants suffering from depression had worse DED symptoms by OSDI, BODI and composite DED sign score. Lower MCS scores, which means worse depression, correlated with higher OSDI scores. The mean corneal staining score was higher in the group with depression. Markers of conjunctival inflammation (cytokines in tears and HLA-DR expression) did not differ by depression status.

The study thus concluded that depression was associated with more severe dry eye symptoms and overall signs and support considering depression as a comorbidity when managing patients with DED. (MedPage Today, March 16; JAMA Ophthalmology, March 10, 2022)