It has come to light in recent years that ophthalmologists have noticed a large number of patients with Dry Eye Disease (DED) also have signs of active depression or anxiety. As DED is a chronic and typically a progressive condition, it can interfere and negatively impact the overall quality of life in patients. This includes aspects of social, psychological functioning, daily activities, and workplace productivity. Symptoms of DED can worsen a patient’s mental health and cause on-set depression or anxiety.
Clear vision depends on a balanced distribution of tears over the ocular surface. Healthy tears are essential for ocular health and comfort; providing nutrients and support the health of cells in the cornea, protect the exposed surface of the eye from infections and lubricate the ocular surface with a healthy coat of proteins and other components. Unbalanced tears lead to discomfort, which is often described as feelings of itchiness, gritty sensation, dryness and even burning. It can also cause blurred vision, sensitivity to light and visual fatigue when the condition becomes progressive.
A study, conducted by Momoko Kitazawa, observed the relationship between DED and mental health, and found that patients with depression and/or anxiety had worse DED symptoms than patients without mental health issues. Another study determined that effective DED treatment could have a positive impact on the symptoms of depression or anxiety. Studies like these have measured the level of anxiety and depression symptoms from DED groups and the control groups. Mental health can be determined on the severity of DED, meaning patients with worse DED symptoms are more likely to show signs of depression and/or anxiety. Most studies concluded that patients suffering from specific symptoms, particularly those with blurred vision, were at a higher risk of experiencing symptoms of depression and/or anxiety.
Symptoms of depression or anxiety disorders can occur before DED, during or after, which means it can be hard to distinguish the cause of a patient’s mental state. What we do know is medications, including antidepressants, can decrease tear secretion and worsen dry eye. Someone who already is being treated for depression or anxiety will typically have accelerated symptoms in DED and even exacerbate depression. This would be counter-productive. Ophthalmologists are not trained in depression or anxiety disorders, however, they can determine whether a patient’s medication may be a contributing factor to their condition.
In most cases, dry eye disease is treatable. However, severe DED can be irreversible and permanently damage the ocular surface for good. Poor ocular health can negatively impact a patient’s mental health and overall wellbeing. Be active and manage your ocular health and prevent damage by using high-quality artificial tears before it gets worse.
Approx. 10 in 100 people suffer from depression and anxiety disorders in the UK. If you or someone else you know is not coping with their mental health problem – we encourage all of our readers to reach out to a professional helpline or service to find the best treatment.