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Johannes Nepp; Depression as ophthalmologic problem in dry eye syndromes. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1480.
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The behavior in depression changes and worsens the state of health as well as reaction on problems. In earlier studies dry eyes were combined with depression and anxiety. Signs and symptoms often are different and many patients suffer from resistance on any treatment. The psychological problems may be one cause of this phenomenon. In this study we observed anxiety and depression, as well as the behavior with dry eyes.
Patients with dry eyes for more than one year were asked about their psychological problems by a questionnaire (TRIPS), to find diagnosis by ICD10. Dry eyes were observed by Lipidlayer thickness, tear meniscus. Break up time, Lissamin and fluorescein staining. The severity of their complaints were estimated by VAS (visual analogue score)1-10. These facts were calculated into a score of dryness, the ‘sicca-score’, which is 0 for normal and 1 for maximum of all tests. The patients were asked about their behavior of disease, complaints and treatment. .
93 patients were observed. The dryness score was 0.43 in 19 patients with depression and 0,54 average in any kind of anxiety of 51 patients. Behavior was very different: patients with anxiety mostly are afraid to do anything by inhibition symptoms. Patients with complaints of depression have reduced motivation to use any treatment and believe that there is no help. Therefore they don’t feel positive changes. In patients with stress symptoms there is no feeling of symptoms by combined loading. Dryness was called a subordinate problem. Therefore complaints increased if combined symptoms appear. Another phenomenon was that Patients don’t feel improvements; any new negative event was changed into negative feeling of dryness. This phenomenon is known in psychosomatic disorders called syndrome of conversion.
Depression aggravates symptoms of dry eyes, but because of low motivation to use treatments and syndromes of conversion patients suffer more. Various psychiatric disorders aggravate troubles of dry eyes by the psychological behaviors but also by the reduced therapeutic approach. Therefore treatment of psychological complaints concomitant to the ophthalmological therapy may improve the disease.
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