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Dry Eye Disease and personality: a systematic review

Alessandro Meduri¹, Emanuele Maria Merlo², Giorgio Sparacino³

¹Ophthalmology Clinic, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.

Frontiers in Medicine

|April 2, 2026

Abstract

Background:

Dry Eye Disease (DED) is a widespread condition associated with ocular discomfort and reduced quality of life. Personality traits may influence symptom perception, disease course and patients' psychological adjustment, suggesting that subjectively experienced symptoms could be shaped by stable individual characteristics. This systematic review aimed to synthesize the available evidence regarding personality in individuals with DED.

Methods:

Following PRISMA guidelines, a systematic search was conducted in November 2025 in PubMed, Scopus and Web of Science using the terms "dry eye disease" OR "dry eye syndrome" AND "personality." Inclusion criteria required full-text, peer-reviewed articles published in English and the use of standardized personality assessment tools. Studies were categorized according to whether DED was clinically confirmed or based on self-reported symptoms. Methodological quality was appraised using the NIH Study Quality Assessment Tools. The review protocol was registered in PROSPERO (CRD420251231024).

Results:

A total of 408 records were identified, and 8 studies met the inclusion criteria. Four studies involved clinically confirmed diagnoses of DED, while four relied on self-reported symptom measures. Across both groups, personality traits, particularly neuroticism and harm avoidance, were associated with greater symptom burden and reduced quality of life. Regression and mediation analyses in several studies supported the influence of personality on symptom perception.

Conclusion:

The findings suggest that personality traits contribute to the subjective experience and clinical impact of DED. However, the predominance of cross-sectional designs and reliance on self-reported measures limit causal interpretation. Further longitudinal and multimethod research is needed to clarify the underlying mechanisms and inform integrated clinical approaches that address both ocular and psychological aspects of DED.

Systematic Review Registration:

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251231024, identifier PROSPERO (CRD420251231024).

Keywords:

DED Dry Eye Disease clinical psychology ophthalmology personality personality traits

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