Letter to the Editor: Interplay between ocular surface function, sleep quality, and psychological factors in dry eye disease

Abstract

Dry eye disease (DED) is increasingly recognized as a complex biopsychosocial condition involving ocular surface dysfunction, systemic inflammation, and psychological distress. The study by Lin et al, published in recent issue of the World Journal of Psychiatry, has highlighted the intricate relationships among sleep quality, anxiety, depression, and ocular symptoms in patients with DED. This study examines how sleep disturbances and psychological status influence ocular surface parameters. The findings advocate a holistic approach to DED management, emphasising the importance of routinely evaluating sleep quality and psychological well-being to improve clinical outcomes and quality of life.

Keywords: Ocular surface function; Dry eye disease; Sleep quality; Depression; Anxiety

Core Tip: Dry eye disease (DED) is not merely a localized ocular disorder but part of a wider systemic and psychological network. Sleep disturbance, anxiety, and depression can exacerbate DED symptoms, while chronic ocular discomfort itself may precipitate poor sleep and mood changes. Risk is higher in pregnant individuals, people with diabetes, patients taking certain medications, and those over 45 years. Depression showed a strong link to increased corneal staining, while both age and sleep disturbances predicted symptom exacerbation. Increased screen time contributes to digital eye strain and incomplete blinking, further destabilizing the tear film. Clinicians should incorporate mental health and sleep screening into DED management to improve both ocular and systemic quality of life.