Paul Implant

Keith Barton, MD

Eyetube

The Hidden Burden of DED: A Biopsychosocial Perspective

Managing this condition may benefit from the inclusion of a mental health element.

Hardeep Kataria, OD, FAAO

Modern Optometry

Dry eye disease (DED) is increasingly recognized as a biopsychosocial condition—one that extends far beyond ocular surface discomfort. DED affects patients’ mental health, time, finances, and overall quality of life. This article reviews the physiological and psychological burdens of DED, drawing from the literature to highlight the need for a more integrated, multidisciplinary approach to care. EFFECT ON QUALITY OF LIFE DED significantly impairs quality of life, workplace productivity, and emotional well-being, particularly in individuals who have more severe symptoms.1 Notably, the effect is greater on women than men.2 Patients frequently face difficulties accessing appropriate care, understanding the chronicity of their condition, and finding effective treatment. A key challenge lies in information access; up to 50% of patients report that their eye care provider is not their primary source of information on treating their DED, with 29% relying on online and social media sources.3 This can lead to misinformation, wasted time, and unnecessary financial burden—ultimately affecting patient outcomes and clinical workflow. ECONOMIC AND TIME BURDENS DED can be time-consuming and expensive to manage. One in four patients reports spending 1 hour each day on treatment—not including the time spent researching and sourcing products.3 Patients may spend up to $1,300 annually on artificial tears alone, which is generally considered a first line of treatment for most optometrists.3 The average cost to manage a patient with DED in the United States was estimated to be $13,302 in 2011—a figure that has likely increased in 2025 due to inflation and the growing cost of specialized therapies.4 More severe disease correlates with higher health care use, multiple visits, and increased out-of-pocket spending. Lack of effective monotherapies, low compliance, and fragmented care models also contribute to reduced workplace productivity. THE BIDIRECTIONAL LINK BETWEEN DRY EYE AND MENTAL HEALTH The relationship between DED, depression, and anxiety is bidirectional. Inflammatory processes, ocular discomfort, and side effects of systemic medication all play a role.

Driving Change with Data

Katherine E. Talcott, MD, and Matthew A. Cunningham, MD, FASRS

Retina Today

Welcome to Retina Today’s annual issue dedicated to diversity and inclusion. While many might consider this a softer, less tangible topic, we retina specialists politely disagree. In fact, diversity in retina has become nearly as data-driven as our clinical trials, and that data is what informs the continual push toward improvement for both patients and practitioners.