Mental Disorders as Influencing Factors for Discordances in the Signs and Symptoms of Dry Eye Disease.

Dry eye disease (DED) is a multifactorial disease of the tear film and ocular surface representing one of the most common problems in ophthalmological practice. Characteristic symptoms of DED include gritty, sandy foreign body sensation as well as visual disturbances that have a negative impact on the patient's daily activities and social life. It is often assumed that the symptoms of dry eye are the main features of this disease, however, the symptoms do not always coincide with the signs and the results of diagnostic tests and the cause of this discordance in perception is still unclear. Numerous studies have been conducted in order to determine the cause of these discrepancies. Mental health disorders may be one of considerable contributing factors for dry eye symptoms and undiagnosed mental health conditions can be an influencing element for unexplained levels of DED symptoms. Depression, anxiety, stress, hypochondriasis, neuroticism, sleep and mood disorders may be associated with the exacerbation of symptoms to degrees that are not consistent with the objective signs related to tear dysfunction as well as changes in the anterior surface of the eye. Thus, a detailed medical history, thorough ophthalmological examination and referral to a psychologist or psychiatrist may be essential in the treatment of patients whose symptoms do not correlate with objective evidence of DED.

[Evaluation of the effect of local corticosteroids in the phototherapy of psoriasis]. / Evaluacija djelovanja lokalnih kortikosteroida u fototerapiji psorijaze.

An open clinical trial was carried out in order to establish to what extent the application of topical corticosteroids with the UVB therapy influences the complete dosage of the UVB radiation required for the clearing of psoriasis and the duration of remission. Out of 30 patients who were administered the suberythemogenic UVB dosage, 15 received a topical corticosteroid and 15 an indifferent ointment (u. emolliens). Although the therapeutic response was initially somewhat more immediate in the corticosteroid--UVB group, there is no statistically significant difference between these two groups in the total UVB dosage required for the remission of the disease. The patients in the topical corticosteroid--UVB group remained in remission longer than the patients in the control group receiving no local corticosteroid.