Down in the (Mouth) Eye

Dry eye disease can certainly be unpleasant and uncomfortable for those affected – but do the symptoms contribute to depression? According to a recent study in women with signs and symptoms suggestive of Sjögren syndrome, the answer appears to be yes.

A research team led by John Gonzales from the University of California, San Francisco, CA, USA, turned to the Sjögren’s International Collaborative Clinical Alliance (SICCA) registry, which has 3,514 patients enrolled from nine international research sites (45.2 percent of participants in the registry have a definitive Sjögren’s syndrome diagnosis). All female participants from the registry (n=3,185) were included in their study, and assessed for depression, keratoconjunctivitis sicca, patient-reported symptoms of dry eye, and overall health.

Overall prevalence of depression in the cohort was 34.9 percent, which the authors noted was “much higher than the 10 percent found in the general population” (1) – perhaps unsurprising given their place on the registry. However, patients who reported dry eye symptoms had a higher odds of depression (p<0.001, compared with symptom-free participants). Moreover, specific dry eye symptoms, such as burning or stinging, were also associated with a higher odds of depression (p<0.001 versus no symptoms). Counterintuitively, more pronounced keratoconjunctivitis sicca (OSS ≤5) was associated with a lower odds of depression – but the authors describe the finding as potentially “artefactual.”

As well as increasing our understanding of the relationship between dry eye symptoms and depression, the authors identified that further investigation to understand the relationship between these two diseases – and the role that neuropathic pain might play – could help improve quality of life for patients.