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Characteristics of Individuals with Dry Eye Symptoms without Clinical Diagnosis: Analysis of a Web-Based Survey

Dysfunctional Coping Mechanisms Contribute to Dry Eye Symptoms

Ophthalmology and Research Services, Miami Veterans Affairs (VA) Medical Center, Miami, FL 33125, USA
Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA
Department of Physical Medicine & Rehabilitation, University of Miami, Miami, FL 33136, USA
Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Miami, FL 33136, USA
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(6), 901;
Received: 21 May 2019 / Revised: 16 June 2019 / Accepted: 20 June 2019 / Published: 24 June 2019
(This article belongs to the Special Issue Dry Eye Syndrome: New Insights on Epidemiology and Management)
Dysfunctional coping behaviors, such as catastrophizing, have been implicated in pain severity and chronicity across several pain disorders. However, the impact of dysfunctional coping has not been examined under the context of dry eye (DE). This study evaluates relationships between catastrophizing and measures of DE, including pain severity and pain-related daily interference. The population consisted of patients seen at Miami Veterans Affairs eye clinic between April 2016 and October 2017. Patients filled out standardized questionnaires assessing symptoms of DE and eye pain, non-ocular pain, mental health, coping behaviors (Pain Catastrophizing Scale, PCS), and pain-related daily interference as a perceived impact on quality of life (Multidimensional Pain Inventory, Interference Subscale, MPI-Interference), and all patients underwent an ocular surface examination. In total, 194 patients participated, with a mean age of 58.8 ± 9.6 years, the majority being male, non-Hispanic, and black. PCS (catastrophizing) was correlated with DE symptom severity, including Dry-Eye Questionnaire 5 (DEQ5; r = 0.41, p < 0.0005), Ocular Surface Disease Index (OSDI; r = 0.40, p < 0.0005), and neuropathic-like eye pain (Neuropathic Pain Symptom Inventory-Eye (NPSI-Eye; r = 0.48, p < 0.0005). Most tear metrics, on the other hand, did not correlate with PCS. Linear regressions showed that PCS, non-ocular pain intensity, and number of pain conditions were significant predictors of DEQ5 (overall DE symptoms), while PCS and non-ocular pain intensity were predictors of NPSI-Eye scores, as were insomnia scores and analgesic use. In a separate analysis, PCS and DE symptoms (OSDI) associated with pain-related interference (MPI-Interference) along with non-ocular pain intensity, post-traumatic stress disorder (PTSD), number of pain conditions, and non-Hispanic ethnicity. These findings suggest that catastrophizing is not significantly related to signs of DE, but is strongly associated to pain-related symptoms of DE and daily interference due to pain. View Full-Text
Keywords: dry eye disease; coping; catastrophizing; chronic pain dry eye disease; coping; catastrophizing; chronic pain
MDPI and ACS Style

Patel, S.; Felix, E.R.; Levitt, R.C.; Sarantopoulos, C.D.; Galor, A. Dysfunctional Coping Mechanisms Contribute to Dry Eye Symptoms. J. Clin. Med. 2019, 8, 901.

AMA Style

Patel S, Felix ER, Levitt RC, Sarantopoulos CD, Galor A. Dysfunctional Coping Mechanisms Contribute to Dry Eye Symptoms. Journal of Clinical Medicine. 2019; 8(6):901.

Chicago/Turabian Style

Patel, Sneh, Elizabeth R Felix, Roy C Levitt, Constantine D. Sarantopoulos, and Anat Galor. 2019. "Dysfunctional Coping Mechanisms Contribute to Dry Eye Symptoms" Journal of Clinical Medicine 8, no. 6: 901.

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