Comorbid health conditions among adult individuals with dry eye disease: a systematic review of quantitative and qualitative studies

INTRODUCTION Dry Eye Disease (DED) is a common condition, affecting approximately 12% globally. Yet, data on the evidence of concurrent comorbidities with DED is unclear. The objective of this review is to provide a comprehensive outline of coexisting health disorders among individuals with DED.METHODS A systematic review focusing on observational and qualitative studies was conducted from the inception to 4 February 2024 across major electronic databases (PubMed, Ovid, EBSCOhost). The risk of bias was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis was completed among the included studies.RESULTS From 9,286 hits, fifty-three studies were included. DED was associated with a high prevalence of mental (depression and anxiety), ocular (meibomian gland dysfunction, cataract, ocular allergy, and neuropathic ocular pain), and systemic disorders (rheumatoid arthritis, hypertension, diabetes, dyslipidemia, thyroid dysfunction, and Sjogren’s disease), as well as other health conditions like sleep disturbances.CONCLUSIONS This synthesis calls for the prevention, detection, and management of comorbidities among DED individuals. Further, this review highlights the need to develop future therapeutic management approaches as well as the concrete clinical implications: structured screening for depression, anxiety, sleep disturbance and metabolic disease at DED diagnosis, with closer monitoring of severe and Sjögren-DED.