Dysfunctional Coping Mechanisms Contribute to Dry Eye Symptoms

Area of Science:

• Ophthalmology
• Psychology
• Pain Medicine

Background:

• Dysfunctional coping mechanisms, like catastrophizing, are linked to pain severity and chronicity in various disorders.
• The role of catastrophizing in dry eye (DE) disease, particularly its impact on pain and daily functioning, remains under-examined.

Purpose of the Study:

• To investigate the relationship between catastrophizing and dry eye measures, including pain severity and pain-related daily interference.
• To determine if catastrophizing predicts dry eye symptoms and pain interference in a patient population.

Main Methods:

• A cross-sectional study of 194 dry eye patients at a Veterans Affairs eye clinic.
• Patients completed questionnaires for DE symptoms (DEQ5, OSDI), eye pain (NPSI-Eye), coping (Pain Catastrophizing Scale, PCS), and daily interference (MPI-Interference).
• Ocular surface examinations were performed; statistical analyses included correlations and linear regressions.

Main Results:

• Catastrophizing (PCS) significantly correlated with dry eye symptom severity (DEQ5, OSDI) and neuropathic-like eye pain (NPSI-Eye).
• Tear metrics showed minimal correlation with catastrophizing.
• Catastrophizing, non-ocular pain, and number of pain conditions predicted overall DE symptoms (DEQ5) and neuropathic eye pain (NPSI-Eye).

Conclusions:

• Catastrophizing is strongly associated with subjective pain symptoms and daily interference in dry eye patients.
• Catastrophizing does not appear to be significantly related to objective signs of dry eye.
• Psychological coping strategies, such as catastrophizing, play a crucial role in the experience of dry eye pain and its impact on quality of life.