A team of researchers from Ghana suggests that as dry eye becomes more severe, patients suffer from a declining quality of life and worsening psychosomatic symptoms, specifically depressive symptoms.

In this clinic-based, cross-sectional study, 211 patients aged 16 to 35 completed three questionnaires: the Ocular Surface Disease Index (OSDI), a short version of the depression, anxiety and stress scale (DASS-21) and the Dry Eye Quality of Life Score (DEQS). The researchers evaluated meibomian gland expression, corneal staining and tear breakup time and conducted Schirmer 1 testing. They then used statistical analysis to determine the relationship between variables. 

The team found a statistically significant association between OSDI scores and DEQS and DASS-21 subscale scores. They note, however, the only statistically significant correlation between clinical test results and DEQS or DASS-21 subscale scores concerned anxiety subscale scores and meibomian gland expression scores OSDI scores correlated with tear breakup time and had a significant effect on DASS-21 subscale scores. When subjects were classified according to the OSDI scores, the team concludes there was a statistically significant difference between all levels of severity of dry eye symptoms for the DEQS.