Ophthalmologists who have treated a large number of patients with dry eye disease have probably noticed that many more of them appear to be depressed, have active depression or have a history of depression than most other patients. Can depression cause dry eyes?
What is DED?
Dry eye disease (DED) is one of the most common conditions found in an eye clinic. DED is a multifactorial disease of the tears and the surface of the eye that causes tear film instability, eye discomfort, and visual impairment. Symptoms of DED include constant eye irritation, foreign body sensation, and blurred vision that lead to negative effects on patients’ daily lives and social functioning, making DED an important public health problem. However, there is a discrepancy between ocular and DED symptoms, and DED symptoms are more suited to extracular conditions than to the parameters of the tear film. DED has recently been linked to other chronic pain conditions and may show a common genetic susceptibility to depression.
Do you have to be afraid of using drugs for depression?
This is a very difficult topic and there is simply no way to generalize it, because the needs of all people, as well as the responses to medicines, are different. But from what I stand for what it is worth:
Most people I know who have gone through the dry eye phase have sometimes suffered from depression AND most of them have used antidepressant medication.
Just because an antidepressant CAN worsen dryness, this does not mean that it WILL (it simply increases the risk), and even if it increases the dryness slightly, it does not mean that it will increase the SYMPTOMS from dryness, and even if it increases it a bit a reasonable compromise to manage depression. There are many drugs that have anticholinergic effects and not everyone can avoid these drugs at all times. Increasing dry eye treatment or comfort measures (such as anti-moisture glasses, etc.) can help balance the situation. On the other hand, if you know effective non-therapeutic tools to deal with depression, the better. But I don’t believe in refusing meds based on the very risk of dry eye. Our overall well-being as people is more important than just our eyes and everyone must call these needs personally at the moment.
Why is depression and anxiety common to dry eyes?
This is not an exhaustive list, but it should help explain why what might seem “trivial” to outsiders can maximally test our coping skills.
Perpetual pain: With dry eye, the pain can be constant and severe. Most people who have never had a dry eye or a serious eye injury have no idea how much pain their eyes can cause. May lead to distraction. When it is chronic, it constantly reduces its own resources.
Impact on life: There is a direct and sometimes dramatic impact on lifestyle. Outdoor activities may become impossible due to air and wind irritation and / or due to extreme sensitivity to light. Work, especially in air-conditioned or heated offices and fluorescent lighting, not to mention computer work, can become much more difficult or even impossible.