Lin YL, Liu HH, Chen SJ, Wan QH, Zhang KP. Correlation of ocular surface function with sleep quality, anxiety, and depression in patients with dry eye disease. World J Psychiatry 2026; 16(1): 112013 [DOI: 10.5498/wjp.v16.i1.112013]
Corresponding Author of This Article
Kai-Ping Zhang, Department of Ophthalmology, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 Jiuyi North Road, Xinluo District, Longyan 364000, Fujian Province, China. kaikaiping@163.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
Observational Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 19, 2026 (publication date) through Dec 31, 2025
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Journal Information of This Article
Publication Name
World Journal of Psychiatry
ISSN
2220-3206
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Lin YL, Liu HH, Chen SJ, Wan QH, Zhang KP. Correlation of ocular surface function with sleep quality, anxiety, and depression in patients with dry eye disease. World J Psychiatry 2026; 16(1): 112013 [DOI: 10.5498/wjp.v16.i1.112013]
Yi-Long Lin, Hai-Hua Liu, Kai-Ping Zhang, Department of Ophthalmology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, Fujian Province, China
Shu-Jin Chen, Department of Ultrasound, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, Fujian Province, China
Qi-Hua Wan, Department of Psychiatry, Longyan Third Hospital, Longyan 364000, Fujian Province, China
Co-first authors: Yi-Long Lin and Hai-Hua Liu.
Author contributions: Lin YL and Liu HH participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; Chen SJ revised the article critically for important intellectual content; Wan QH provided technical support; Zhang KP designed the study; Lin YL and Liu HH made equal contributions to this work and are co-first authors. All author approval the final manuscript.
Institutional review board statement: The study was approved by the Medical Ethics Committee of Longyan First Affiliated Hospital of Fujian Medical University (Approval No. LTREC2022-K016-01).
Informed consent statement: All study participants, or their legal guardians, provided written informed consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai-Ping Zhang, Department of Ophthalmology, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 Jiuyi North Road, Xinluo District, Longyan 364000, Fujian Province, China. kaikaiping@163.com
Received: August 8, 2025 Revised: September 13, 2025 Accepted: October 24, 2025 Published online: January 19, 2026 Processing time: 144 Days and 19 Hours
Abstract
BACKGROUND
Dry eye disease (DED) is a multifactorial ocular surface disorder with rising prevalence. It is closely related to systemic health and psychological factors, such as sleep and mood disorders, which significantly impact the quality of life of patients.
AIM
To explore the correlations between ocular surface function, sleep quality, and anxiety/depression in patients with DED.
METHODS
This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025. Ocular surface was assessed using the ocular surface disease index (OSDI), tear film break-up time, fluorescein staining score, and Schirmer I test. The Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were used to evaluate sleep quality and anxiety/depression levels. Correlation and linear regression analyses were used to explore the relationships.
RESULTS
The mean PSQI score of the patients was 9.94 ± 2.18; the mean SAS score was 47.30 ± 4.90, and the mean SDS score was 50.08 ± 5.52. These suggested a prevalence of sleep and psychological abnormalities. There was a significant correlation between the indicators of ocular surface function (OSDI, tear film break-up time, fluorescein staining, and Schirmer I test) and PSQI, SAS, and SDS scores (P < 0.05). Moreover, multiple regression revealed that age ≥ 50 years (β = 1.55, P = 0.029), PSQI scores (β = 0.58, P < 0.001), SAS scores (β = 0.17, P = 0.017), and SDS scores (β = 0.15, P = 0.019) were independent predictors of the OSDI scores.
CONCLUSION
Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression, emphasizing the need for holistic clinical management.
Core Tip: This study reveals significant correlations between ocular surface dysfunction and poor sleep quality and anxiety/depression in patients with dry eye disease. Sleep and mood disorders were prevalent among these patients, and factors such as age, sleep quality, and psychological scores independently predicted symptom severity. These findings underscore the importance of integrated, multidisciplinary management for dry eye disease, addressing both ocular and systemic health.
