Nasolacrimal Duct Obstruction May Be Tied to Adverse Psychological Outcomes

Individuals with nasolacrimal duct obstruction may be at risk for anxiety and depression.

Nasolacrimal duct obstruction may be associated with depression and severe anxiety, according to a study published in Frontiers in Psychiatry. Clinicians should screen for these risk factors and refer them for appropriate mental health treatment when necessary, the report suggests.

Researchers included 344 participants with a history of nasolacrimal duct obstruction who underwent dacryocystorhinostomy (DCR) at a single center between January 2016 and January 2021 in the investigation. The team conducted telephone-based surveys and used the 9-item Patient Health Questionnaire (PHQ-9) and State-Trait Anxiety Inventory (STAI) to quantify depression and anxiety levels. PHQ-9 scores of 5 or greater and STAI scores of 55 or greater were considered to be clinically significant. The prevalence of dry eye, glaucoma, and cataract were 29.4%, 1.5%, and 24.1%, respectively, among the cohort.

Depression and anxiety are common in patients with NLDO who underwent DCR and have a significant impact on patient adherence and satisfaction.

Overall, 13.1% of patients with nasolacrimal duct obstruction had mild to severe depression and 63.4% had severe anxiety, according to the report. Hypertension, dry eye, and cataract were associated with mild to severe depression (P =.018; P =.045; and P =.035, respectively). Dry eye was also associated with severe anxiety (P =.007).  

Dry eye was positively correlated with both PHQ-9 and STAI scores (P ≤.001 for both) and the incidence of depression was higher among individuals with dry eye compared with individuals without the condition (42.2% vs 27.4%). Male sex and income level demonstrated a significant negative correlation with both PHQ-9 and STAI scores, the report shows.

“Depression and anxiety are common in patients with [nasolacrimal duct obstruction] who underwent DCR and have a significant impact on patient adherence and satisfaction,” according to the researchers. “Preoperative evaluation of relevant risk factors and early intervention are helpful to improve the prognosis and improve their compliance with medical recommendations.”

The cross-sectional design and single center enrollment are acknowledged limitations to the research.

This article originally appeared on Optometry Advisor


Guo Y, Wu D, Jin Y, Tian Y, Li X. Prevalence and risk factors for depression and anxiety in patients with nasolacrimal duct obstructionFront Psychiatry. Published online August 8, 2023. doi:10.3389/fpsyt.2023.1174404