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

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.