Patients who are newly diagnosed with obsessive-compulsive disorder (OCD), even in the absence of psychiatric drug use, are at elevated risk for dry eye disease (DED), according to research published in Cornea.
Researchers conducted a prospective study to evaluate the association between newly-diagnosed OCD and DED in 30 treatment-naive patients with OCD and 30 healthy controls wherein researchers obtained the Ocular Surface Disease Index (OSDI) values, tear breakup time, Schirmer I test, corneal and conjunctival staining grade, and neutrophil-to-leucocyte values for all participants.
In the patients with an OCD diagnosis, the study found significantly higher values in OSDI (P =.001), corneal Oxford scoring (P =.02), and conjunctival Oxford scoring (P =.04), with consistently lower values in the Schirmer I test (P =.043) and tear breakup time (TBUT) (P =.001). Also, mean neutrophil-to-leukocyte ratio values were significantly higher in the OCD group compared with controls (P =.001).
The researchers note that these findings suggest inflammation may be partially responsible for this relationship. Another contributing factor, they explain, could be neurological.
“In addition to the inflammatory process, it has been found that neurotransmitter dysregulation, particularly serotonin, may contribute to the pathogenesis of OCD,” the study explains. “It has been postulated that disturbances in the serotonin neurotransmitter system may affect the meibomian glands and cause tear film deficiency in depressive patients.”
The study elaborates on this point, pointing out that specifically, this neurological reaction may lead to changes in the composition of tears, increased Oxford rating, and a decreased TBUT.
Finally, the researchers make clear that, although OSDI values for OCD patients (mean = 30.8) were significantly higher than those of control patients (mean = 20.8), this factor alone was not enough to constitute DED in the OCD group.
“Interestingly, although all objective dry eye parameters were worse in patients with OCD compared with the control group, none of them was sufficient to diagnose dry eye, except for TBUT,” the study explains.
Eroglu FC, Gediz BS, Ozturk M, Kazancı B. Association between dry eye disease and newly diagnosed obsessive-compulsive disorder. Cornea. 2021;40(7):817-821. doi:10.1097/ICO.0000000000002724.