Dry eye disease (DED) represents a common health problem in the general population. Previous studies have demonstrated that the subjective symptoms of dry eye are associated with several psychological factors, including depression, anxiety and post-traumatic stress disorder. However, there is a lack of empirical information about the mechanisms underlying the relationships between DED and various psychological symptoms. In light of emerging evidence of its trans-diagnostic nature, anxiety sensitivity (i.e. AS) represents one promising factor for further understanding DED. The present study aimed to explore whether anxiety sensitivity plays a role in the perception of DED symptoms in a community-based sample of adults aged 20–89 years (N = 381; M = 39.72, SD = 12.6). A dry ocular surface was reported by 22.8% of the participants. As expected, women more often reported symptoms of dry eye that could be categorized as moderate to severe. The findings demonstrated that AS, and the AS-psychological concerns dimension in particular, predict the intensity of dry eye symptoms above and beyond depressive and anxiety symptoms. These findings add to a growing body of work underscoring the relevance of AS in increasing the risk of chronic medical conditions.

Dry eye disease (DED) is often comorbid with psychiatric conditions and psychological disturbances like anxiety and depression. The psychological symptoms are mostly considered to be a consequence of DED or a side-effect of medication. However, the possible psychological etiology of DED is seldom explored. This study explores the relationship between anxiety sensitivity (AS), unpleasant emotional states, and the severity of DED symptoms in a healthy general population sample in Croatia. A total of 766 adults (62.27% females) aged between 18 and 88 years completed an online survey consisting of the Ocular Surface Disease Index (OSDI), Anxiety Sensitivity Index (ASI), and Depression Anxiety Stress Scales (DASS21) together with socio-demographic data. The results revealed significant positive correlations between ASI, emotional states, and OSDI (r = 0.25–0.29, p < 0.01). Mediation analysis showed that DASS21 significantly mediates the relationship between ASI and OSDI (B = 0.1, CI = [0.004, 0.2]). Highly anxiety sensitive people are more sensitive to DED symptoms, which additionally increases in a state of emotional stress. Thus, DED symptoms are perceived more intensely and frequently than in less sensitive people. Understanding these associations is crucial for comprehensive DED management, indicating potential benefits from addressing psychological health in DED patients and eye health in psychiatric patients.