Background/Objectives: Chronic topical antiglaucoma therapy may affect the ocular surface. We assessed documented dry eye disease (DED) and its associations with active-ingredient burden, treatment duration, and preservative exposure. Methods: This retrospective cross-sectional study included 357 adults receiving topical antiglaucoma therapy at a tertiary center who had complete treatment and ocular-surface data. Ocular-surface testing was prompted by symptoms or clinical judgment. The first eligible visit identified during chronological record review was analyzed for each patient. DED was based on the treating ophthalmologist’s documented diagnosis. Logistic regression evaluated treatment-related factors. Results: DED was documented in 171/357 patients within this selected sample (47.9%; 95% CI 42.8–53.1%). Prevalence was higher with at least two versus one active IOP-lowering ingredient (60.6% vs. 23.1%; p < 0.001). Each additional ingredient was associated with higher DED odds after adjustment for age, sex, and glaucoma subtype (adjusted odds ratio [aOR] 2.65, 95% confidence interval [CI] 1.88–3.74). Longer treatment duration was also associated with higher odds (aOR 1.12 per 12 months, 95% CI 1.05–1.20). In the linear extended model, active-ingredient count was not associated with documented DED (aOR 1.02, 95% CI 0.69–1.51), whereas an exclusively preservative-free regimen was associated with lower odds (aOR 0.011, 95% CI 0.001–0.084) and fixed-combination therapy with higher odds (aOR 3.23, 95% CI 1.74–5.98). However, categorical modeling of ingredient count significantly improved extended-model fit (likelihood-ratio p < 0.001), indicating sensitivity to functional form. Documented DED occurred in 1/91 (1.1%) exclusively preservative-free patients versus 170/266 (63.9%) preserved-exposure patients, with sparse PF events limiting interpretation. Conclusions: Documented DED was common in this selected cohort undergoing ocular-surface assessment. Active-ingredient count was associated with DED in the primary adjusted model, but its interpretation in the extended model depended on the functional form used. The marked inverse association with an exclusively preservative-free regimen requires prospective confirmation because sparse data, limited overlap between treatment groups, treatment selection, and residual confounding preclude causal inference.

Background: Psychological outcomes among patients receiving anti-vascular endothelial growth factor (anti-VEGF) therapy for diabetic macular edema (DME) remain insufficiently investigated. This study assessed symptoms of depression, anxiety, and stress, as well as life satisfaction, in patients undergoing intravitreal anti-VEGF therapy for DME. Methods: This cross-sectional study included patients receiving intravitreal anti-VEGF therapy for DME at Clinical Hospital Centre Osijek, Croatia, from 15 December 2025 to 15 February 2026. Depression, anxiety, and stress symptoms were assessed using the Depression Anxiety Stress Scale-21 (DASS-21), and life satisfaction using the Satisfaction with Life Scale (SWLS). Best-corrected visual acuity (BCVA) was categorized as ≥0.5, 0.1–0.49, or <0.1. Multivariable linear regression models were adjusted for age, sex, and diabetes duration. Results: A total of 156 patients were included; 51.3% were male, and the median age was 71 years (IQR 64.75–76.25). Mild-to-extremely severe symptoms of depression, anxiety, and stress were present in 39.7%, 48.7%, and 28.8% of participants, respectively, while 37.2% reported some degree of life dissatisfaction. In adjusted analyses (N = 155), worse-seeing eye BCVA < 0.1 was associated with higher stress scores compared with BCVA ≥ 0.5 (B = 2.667, 95% CI 0.526–4.808, p = 0.015; standardized effect size = 0.583). Associations with depression and anxiety were not significant, and no BCVA associations remained significant after Benjamini–Hochberg correction. The number of intravitreal anti-VEGF injections was not significantly associated with the assessed psychological outcomes and life satisfaction in univariable analyses. Conclusions: These findings highlight the importance of assessing psychological symptoms and life satisfaction in patients receiving anti-VEGF therapy for DME. Further research should examine the associations of visual acuity, the number of anti-VEGF injections, and other clinical and psychosocial factors with these outcomes.