The Association Between Dry Eye Disease And Mental Health: A Save Sight Dry Eye Registry Study
Published 2023 - 41st Congress of the ESCRS
Reference: PO0833 | Type: Free paper | DOI: 10.82333/fyqb-3663
Authors: Stephanie Watson 1 , Himal Kandel 1 , Fiona Stapleton 2 , Laura Downie 3 , Gerd Geerling 4 , Saaeha Rauz 5 , Alberto Recchioni 5 , Vincent Daien 6 , Fanny Babeau 6 , Jennifer Craig 7 , Francisco Arnalich* 8 , David Mingo 8
1Save Sight Institute,The University of Sydney,Sydney,Australia, 2School of Optometry and Vision Science,University of New South Wales,Randwick,Australia, 3Optometry and Vision Sciences,University of Melbourne,Melbourne,Australia, 4Department of Ophthalmology,University Hospital Duesseldorf,Duesseldorf,Germany, 5Academic Unit of Ophthalmology,Institute of Inflammation and Aging,Birmingham,United Kingdom, 6Department of Ophthalmology,Centre Hospitalier Universitaire (CHU) Montpellier,Montpellier,France, 7Department of Ophthalmology,University of Auckland,Auckland,New Zealand, 8Department of Ophthalmology,Hospital Universitario Ramon y Cajal,Madrid,Spain
Purpose
The primary objective of this study was to determine the association of signs and symptoms of dry eye disease with mental health.
Setting
A cross-sectional, real-world study was conducted utilising prospective, web-based, international Save Sight Dry Eye Registry data collected from routine clinical practice. Data from four ophthalmology practices contributed by fourclinicians were analysed.
Methods
The Patient Health Questionnire-4 (PHQ-4) a validated short questionnaire for anxiety and depression used to screen for mental health status, was completed by 180 patients (358 eyes) with a diagnosis of dry eye disease. Demographic (e.g. age, sex), clinical (e.g. visual acuity, dry eye signs) and patient-reported outcome data [PHQ, Ocular Surface Disease Index (OSDI), and Ocular Comfort Index (OCI)] were analysed. Rasch analysis was conducted on the PHQ, OSDI and OCI data using the Andrich Rating Scale Model to obtain interval-level scores. Associations of PHQ scores with age, visual acuity, dry eye signs and symptoms were evaluated with Pearson’s correlation coefficient. A p value <0.05 was considered statistically significant.
Results
The mean age of the participants was 57.0 ± 15.1 years with 150 (83.3%) females. Evaporative dry eye was the most common subtype of dry eye disease n =341 (95.3%) vs 173 (48.3%) aqueous deficiency, and 30 (8.4%) corneal neuropathic pain. Mean VA was 78.3±16.3 logMAR letters. PHQ scores correlated significantly with OSDI-Overall (Pearson’s r = 0.47), OSDI-Activity limitation (0.45), OSDI-Symptoms (0.43), OCI-Overall (0.47), OCI-Frequency (0.47), OCI-Intensity (0.42) scales scores (all p <0.05). The PHQ scores were not correlated with tear-film break-up time (Pearson’s r = -0.07), ocular surface staining (0.03), visual acuity (0.07) and age (-0.03; all p >0.05).
Conclusions
This real-world observational study found that the worse dry eye symptoms and visual functioning were associated with worse anxiety and depression scores. Mental health scores were not associated with patient’s age, visual acuity, tear-film break-up time, nor ocular surface staining. Clinicians should be aware that the mental health of symptomatic dry eye patients, in particular those with poor visual function, may be compromised.