Connection Between Dry Eye and Mental Health: A Big Question to Sustainable Eye Care

Aakanksha Pathania, B.Optom

Optometrist

In 2020, the whole world got a huge punch by COVID 19, devastating a huge population. With time, people adapted to the environment. New normal life began, social distance, sanitizations, masks became a part of routine.⁽¹⁾ However, there was still one thing people couldn’t overcome, that was, mental health. Mental health was a repercussions of the challenges COVID 19 brought into everyone’s life.

The Pandemic also affected the working patterns as millions of employees were asked to carry on their works from home, which sounded exciting in beginning but had its own repercussions like long work hours, no outdoor activity, extended screen time made them slip into depression by creating a severe effect on mental health.⁽²⁾

Mental health affected quality of life, bringing a question to sustainable healthcare.⁽²⁾ Although new normal enforced ophthalmic aid to anticipate new normal life, a surprising connection came between dry eye and mental health.

According to DEWS, Dry eye is a complex disease involving tear and ocular surface resulting  in discomfort, virtual disturbance and tear film instability which can cause potential damage to the ocular surface which is associated by increased osmolarity of the tear film and inflammation of the ocular surfaces.⁽³⁾

Dry eye is an accelerating disease which requires timely treatment otherwise can influence the mental health condition of patients.⁽⁴⁾ Patients suffering from dry eye symptoms suffer from low work productivity, decreased quality of sleep, and a negative impact on their mental health. Dry eye disorder (DED) patients are expected to face trouble with everyday chores meddling with general and emotional health and daily activities. Working on bigger screens usually involves a wide palpebral aperture, which escalates the tear film evaporation speed.⁽⁵⁾

The link between dry eye and mental health is reciprocal, patients with mental health hang around TV and computers accelerating dry eye conditions, even the new generations of antidepressant like SSRI (Selective serotonin reuptake inhibitor) and SNRI(Serotonin and norepinephrine reuptake inhibitors) display increased threat of DED.⁽⁵⁾

Nevertheless, mental health and dry eye disorder both influence sustainable development. Approachable and economical eye care is important to achieve sustainable development goals. Dry eye syndrome might cause fluctuation in vision, increase glare and reduce contrast sensitivity. ⁽⁷⁾ Dry eye syndrome patients have unsteady tear film which can be managed temporarily by frequent blinking; however, it do not justify sustainable development and severe symptoms may cause difficulty in keeping eyes open.⁽⁷⁾

Mental illness is a chief reason for the worldwide burden of disease. Without improving the mental health status, we cannot achieve the goals of sustainable health care.⁽⁶⁾ People who are affected by mental health should be included in development interventions.

Ophthalmologist and psychiatrists need to understand the impact of the mental health, medications and dry eye disorder on the quality of life and sustainable health care^.(8)

References:

1. Tria, J. Z. (2020). The COVID-19 pandemic through the lens of education in the Philippines: The new normal. International Journal of Pedagogical Development and Lifelong Learning, 1(1), 2-4.
2. Xie, X., Siau, K., & Nah, F. F. H. (2020). COVID-19 pandemic–online education in the new normal and the next normal. Journal of information technology case and application research, 22(3), 175-187.
3. Lemp, M. A., & Foulks, G. N. (2007). The definition and classification of dry eye disease. Ocul Surf, 5(2), 75-92.
4. Al-Mohtaseb, Z., Schachter, S., Shen Lee, B., Garlich, J., & Trattler, W. (2021). The relationship between dry eye disease and digital screen use. Clinical Ophthalmology, 3811-3820.
5. Uchino, M., & Schaumberg, D. A. (2013). Dry eye disease: impact on quality of life and vision. Current ophthalmology reports, 1, 51-57.
6. Izutsu, T., Tsutsumi, A., Minas, H., Thornicroft, G., Patel, V., & Ito, A. (2015). Mental health and wellbeing in the Sustainable Development Goals. The Lancet Psychiatry, 2(12), 1052-1054.
7. Zhang, J. H., Ramke, J., Jan, C., Bascaran, C., Mwangi, N., Furtado, J. M., … & Burton, M. J. (2022). Advancing the Sustainable Development Goals through improving eye health: a scoping review. The Lancet Planetary Health, 6(3), e270-e280.
8. Kaštelan, S., Bakija, I., Bogadi, M., Gverović Antunica, A., Gotovac, M., & Šimunović Filipčić, I. (2021). Mental disorders as influencing factors for discordances in the signs and symptoms of dry eye disease. Psychiatria Danubina, 33(suppl 4), 588-595.

Cover Image Courtesy – https://www.dryeyefoundation.org/dehhblog/2020/9/6/august-28-2020-dry-eye-and-our-mental-health