Dry eye disease and depression-anxiety-stress: A hospital-based case control study in Turkey

Objective: The aim of the present study was to investigate the association between dry eye disease (DED) and psychosomatic conditions, such as depression, stress, and anxiety, and the distribution of associated risk factors. Methods: In this case control study, the sample consisted of 121 DED subjects and 242 control subjects. Each subjects was diagnosed as having DED or not by an ophthalmologist. Ocular Surface Disease Index and Depression Anxiety Stress Scales were administered to all subjects. Data were analysed using chi-square and Mann Whitney U tests as a univariate analysis and multiple logistic regression as a multivariate analysis. Results: Of 1,458 consecutive outpatients, clinically diagnosed DED was present in 121 individuals (8.3%). There was a significant relationship of family history of DED (OR, 1.43; 95% CI, 0.84-2.41), chronic disease history (OR, 2.84; 95% CI, 1.66-4.87), OSDI score (OR, 1.07; 95% CI, 1.97–4.06), depression (OR, 2.06; 95% CI, 1.30-3.27), anxiety (OR, 2.66; 95% CI, 1.67-4.23), and stress (OR, 2.33; 95% CI, 1.48-3.67) with DED. Conclusion: Individuals with depression, anxiety and stress are more likely to experience DED. In addition to confirming some well-known risk factors, this study has found new associations between DED and a family history of DED and the presence of stress.