Post-Traumatic Stress Disorder (PTSD) which is defined as an anxiety disorder which is characterized by reliving a psychologically traumatic event, long after any physical danger involved has passed, through flashbacks and nightmares. They are among the most common of mental illness problems.
Mental Illnesses present more severe dry eye symptoms, but not clinical signs.
Studies conducted in Asian populations have found that patients with anxiety and depression reported to have more dry eye symptoms when compared to a control group.1 When a geriatric Korean population was studied, the depression scores were correlated with dry eye symptoms, but not with clinical signs.2 (Complain about symptoms but actualy dry eye measurements do not indicate the extent of the severity). Additionally, another clinical study showed a greater prevalence of dry eye symptoms and clinical measurements (clinical signs of dry eye) in Chinese individuals with depression and anxiety disorders.3
These studies indicate complaining about dry eye symptoms seem to be directly related to the extent of mental illness, not the clinical disease. The current research study is trying to evaluate if this is true.
This current research study focuses on veterans with PTSD and depression and it's impact on dry eye symptoms and clinical signs. This study was done in Western population, in contrast to the studies mentioned previously. Patients were recruited from the Miami Veterans Affairs Eye Clinic. The authors compared dry eye symptoms using the Dry Eye Questionnaire 5 [DEQ5] to tear film indicators obtained by clinical examination. DEQ5 measures how severe the symptoms are based on what the individual experience.
The results showed that the DEQ5 scores were higher in the PTSD and depression sub-groups compared to the control group without mental illness. A higher number of patients in the PTSD and depression groups had severe dry eye symptoms and showed a DEQ5 score of ≥12. No significant differences in tear film tests and MGD evaluation were found among the three groups which is similar to some of the Asian studies. However, statistical analysis indicated that a PTSD diagnosis and use of certain medication (selective serotonin reuptake inhibitors) were significantly associated with severe symptoms of dryness.
Another words, if they are on drugs, the symptoms seem to be more severe.
This study suggests that the dry eye symptoms noted in veterans should be carefully evaluated as it involves different factors and extends beyond tear dysfunction.
This brief extract is from Current Eye Res. Jan. 2011., Vol. 36, pages 1-7.
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References
1. Li M, Gong L, Sun X, Chapin WJ. Anxiety and depression in patients with dry eye syndrome. Curr Eye Res. Jan 2011;36(1):1-7.
2. Kim KW, Han SB, Han ER, et al. Association between depression and dry eye disease in an elderly population. Invest Ophthalmol Vis Sci. 2011;52(11):7954-7958.
3. Wen W, Wu Y, Chen Y, et al. Dry eye disease in patients with depressive and anxiety disorders in Shanghai. Cornea. Jun 2012;31(6):686-692.
