AAOpt 2026: The human cost of dry eye

Kaleb Abbott, OD, MS, FAAO, assistant professor at the University of Colorado School of Medicine, and clinician in a dry eye clinic, discusses dry eye as a condition that affects patients well beyond eye discomfort and visual symptoms in summary of one of his sessions at American Academy of Optometry (AAOpt) Annual Meeting 2026 in Anaheim, California. The central point of the session, titled “The Human Cost of Dry Eye: Pain, Productivity, and Psychological Burden,” is that dry eye’s impact should be understood in the context of a patient’s overall health and quality of life.

A major challenge in treating dry eye is that observable signs on the front of the eye do not closely correspond to how severe a patient’s symptoms feel. Abbott says that factors outside the eye—including anxiety, depression, other mental health conditions, psychiatric disorders, and poor sleep—are among the strongest predictors of dry eye symptoms. These factors may heighten pain perception or sensitize the nervous system, so a patient with relatively mild clinical signs can still experience substantial discomfort. He therefore encourages practitioners to consider the whole clinical picture, including sleep, diet, mental health, and other conditions that could affect how a patient experiences symptoms.

Abbott describes the relationship between dry eye and poor sleep as bidirectional. Poor sleep can reduce tear secretions, increase tear osmolarity, shorten tear breakup time, and heighten corneal nerve sensitivity, potentially worsening both dryness and symptoms. Conversely, dry eye can interfere with sleep: patients may go to bed later, wake earlier, or be disturbed during the night by eye irritation.

The talk also emphasizes that dry eye can affect multiple aspects of daily life. In addition to discomfort, it can cause visual symptoms and is associated with anxiety, depression, and other chronic pain syndromes, including fibromyalgia. Abbott argues that the term “dry eye” can sound less serious than the condition’s broader effects warrant. Clinicians should recognize these connected burdens and address relevant factors individually.

Workplace productivity is another concern. Abbott notes that highly symptomatic dry eye was identified as a significant contributor to reduced productivity, ranking just after depression in the studies he references. Its effects can include both absenteeism and presenteeism—being at work but unable to work effectively. On average, patients may take two to five days off work to attend appointments or cope with discomfort.

Finally, Abbott distinguishes direct financial expenses, such as visit copays, over-the-counter lubricating drops, prescription drops, and cash-pay procedures, from indirect costs. These may include lost work time and travel expenses, such as gas for appointments. Overall, he presents dry eye as a complex condition with interconnected clinical, emotional, sleep-related, occupational, and financial effects.