An important contributing factor in dry eye disease: somatization.

PURPOSE: Somatization is an important mental process that may causes medically unexplained and treatment-resistant somatic symptoms. The aim of the study is assess the presence of somatization in patients with dry eye disease (DED). METHODS: Eighty-eight patients with no objective DED finding and ongoing DED treatment were included in this prospective and observational study. Patients with subjective symptoms formed the symptom group and patients without subjective symptoms formed the control group. All patients were scored with the Turkish version of the Ocular Surface Disease Index (OSDI), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Symptom Checklist-90-R (SCL-90R) somatization subscale, Toronto Alexithymia Scale (TAS), Pain Catastrophizing Scale (PCS), and Symptom Interpretation Questionnaire (SIQ). RESULTS: Mean OSDI score was significantly higher in the symptom group than in the control group. The mean HAM-D and HAM-A outcomes did not differ between the groups. The mean SCL-90R somatization subscale, TAS, and PCS scores were significantly higher in the symptom group than in the control group. In the SIQ, somatic attributional style score was significantly higher in the symptom group than in the control group. The SCL-90R somatization subscale, PCS, and somatic attributional style scores had positive and mild-moderate correlation with OSDI scores in the symptom group. The TAS score had positive and moderate correlation with OSDI scores in all sample analyses. CONCLUSION: Somatization should be considered in patients with DED with chronic ocular surface symptoms. Presence of subjective symptoms resistant to treatment may be an indicator of somatization.

Influence of visual acuity level on sexual function in patients with cataract.

Purpose: To assess the association of sexual function with visual acuity. Methods: Patients were included in the mild to moderate visual impairment (MVI), severe visual impairment (SVI), and profound visual impairment (PVI) groups based on bilateral corrected distance visual acuity. All patients completed the Turkish version of the International Index of Erectile Function (IIEF) and Glombok-Rust Inventory of Sexual Satisfaction (GRISS) scales before and at 1 month after the cataract surgery. Results: Mean IIEF scores did not improve after cataract surgery in the MVI group (P > 0.05). Sexual desire, intercourse satisfaction, overall satisfaction, and total IIEF score were significantly improved after cataract surgery in both the SVI and PVI groups (P < 0.05). Mean GRISS subscale scores did not improve after cataract surgery in the MVI group (P > 0.05). Non-sensuality, avoidance, dissatisfaction, infrequency, noncommunication, and total GRISS score were significantly improved after cataract surgery in both the SVI and PVI groups (P < 0.05). Conclusion: The study results documented the association of low visual acuity and decreased sexual desire and satisfaction and revealed the beneficial effect of visual improvement.

Improvement in psychiatric symptoms after strabismus surgery in adolescent patients in long-term follow-up.

AIMS: To assess the psychological effects of preoperative primary eye position and surgical correction of strabismus in adolescent patients. METHODS: Eighty-three adolescent patients with exotropia were included in this observational and prospective study. Patients with preoperative manifest exotropia formed the manifest exotropia group. Patients with intermittent exotropia that had orthophoria with overcorrecting minus lenses and recently increased frequency of manifest phase were indicated for surgery and formed the latent deviation group. All patients were scored with the Turkish version of the Social Appearance Anxiety Scale (SAAS), depression subscale of Hospital Anxiety and Depression Scale (HAD-D) Brief Fear of Negative Evaluation Scale (BFNE), state anxiety subscale of State-Trait Anxiety Inventory (STAI-S) and trait anxiety subscale of State-Trait Anxiety Inventory (STAI-T) before and 1 year after strabismus surgery. RESULTS: The mean preoperative scores of the HAD-D, SAAS, BFNE, STAI-S and STAI-T before strabismus surgery were significantly higher in the manifest exotropia group than in the latent deviation group (p≤0.001 for all). Surgical correction significantly improved the outcomes of all scales in the manifest exotropia group (p≤0.001 for all). Outcomes of the STAI-S and STAI-T significantly improved in the latent deviation group after the surgery (p=0.008, p=0.006, respectively), whereas outcomes of the HAD-D, SAAS and BFNE did not improve (p=0.079, p=0.071, p=0.127, respectively). The mean postoperative scores of all scales did not differ between the two groups (p>0.05 for all). CONCLUSIONS: Strabismus has psychological consequences in adolescent patients, and the visible eye deviation caused by strabismus is a strong indicator of psychological distress.