273895 Dry Eye Syndrome, Posttraumatic Stress Disorder (PTSD), and Depression in Older Male Veterans

Monday, October 29, 2012

Cristina A. Fernandez, MSEd , Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL
Anat Galor, MD, MSPH , Miami VA Healthcare System, Miami Veterans Administration Medical Center/University of Miami Miller School of Medicine Bascom Palmer Eye Institute, Miami, FL
Kristopher L. Arheart, EdD , Department of Epidemiology & Public Health, University of Miami Miller School of Medicine, Miami, FL
Hermes Florez, MD , Department of Endocrinology and Geriatrics, University of Miami Miller School of Medicine/Miami Veterans Administration Medical Center, Miami, FL
Dominique Musselman, MD, MSCR , Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL
Manuel A. Ocasio, BA , Department of Epidemiology & Public Health, University of Miami Miller School of Medicine, Miami, FL
David J. Lee, PhD , Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, FL
Introduction: Dry eye syndrome (DES) is a worldwide public health problem that negatively affects one's ability to work and function. It is the leading cause of visits to eye clinics, and DES medications account for approximately $1.9 billion annually in the US.

Methods: Male patients aged 50+ were recruited from the Miami VA eye clinic and received examination of tear film parameters (N=250) and completed a Dry Eye Questionnaire (DEQ5). PTSD and Depression ICD-9 codes and prescription medications were obtained from medical records. The main outcome measures were self-reported dry eye symptoms and clinical signs of DES; scores were compared across those with PTSD (n=22), depression (n=40), and a group with neither diagnosis (n=186). T-test, Chi-square, and logistic regression analyses were used to compare groups.

Results: The PTSD and depression groups had significantly higher self-reported dry eye symptoms compared to those without these diagnoses, but there were no significant differences in tear film parameters among groups. Logistic regression comparing those with severe self-reported dry eye symptoms versus those with less severe or no symptoms found antidepressant use (OR=2.34; 95% CI=1.15-4.78) and PTSD (OR=3.69; CI=1.18-11.53) to be significant predictors after controlling for demographic and health-related variables. There was a non-significant trend for those with depression to have higher symptoms (OR=1.99; CI=0.89-4.48).

Discussion: PTSD and antidepressant medications are associated with more severe self-reported dry eye symptoms. Evaluation of ocular health in veterans with PTSD or depression is warranted, particularly considering the potential impact of DES symptoms on physical and mental well-being.

Learning Areas:
Chronic disease management and prevention
Clinical medicine applied in public health
Other professions or practice related to public health
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Identify which psychiatric diagnoses impact dry eye symptoms 2. Explain the public health impact of comorbid dry eye syndrome and mental illness in older males 3. Identify how psychiatrists and ophthalmologists can collaborate to increase the overall health and wellbeing of veterans

Keywords: Vision Care, Veterans' Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I assisted with this project and am involved in ocular epidemiology research groups.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.