REVIEW article
Front. Med.
Sec. Ophthalmology
Dry Eye Disease and Personality: A Systematic Review
Alessandro Meduri 1
Emanuele Maria Merlo 2
Giorgio Sparacino 3
Laura De Luca 1
Maura Mancini 1
Giovanni William Oliverio 1
Paola Palino 1
Orlando Silvestro 4
Gabriella Martino 5
Pasquale Aragona 1
1. Ophthalmology Clinic, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Universita degli Studi di Messina, Messina, Italy
2. Department of Biomedical Sciences, Dental Sciences and Morpho-functional Imaging,University of Messina, Messina, Italy
3. Course Degree in Medicine and Surgery, Universita degli Studi di Messina, Messina, Italy
4. Department of Health Sciences, Universita degli Studi Magna Graecia di Catanzaro, Catanzaro, Italy
5. Department of Clinical and Experimental Medicine, University of Messina, Universita degli Studi di Messina, Messina, Italy
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Abstract
Background: Dry Eye Disease (DED) is a widespread condition associated with ocular discomfort and reduced quality of life. Personality traits may influence symptom perception, disease course and patients' psychological adjustment, suggesting that subjectively experienced symptoms could be shaped by stable individual characteristics. This systematic review aimed to synthesise the available evidence regarding personality in individuals with DED. Methods: Following PRISMA guidelines, a systematic search was conducted in November 2025 in PubMed, Scopus and Web of Science using the terms "dry eye disease" OR "dry eye syndrome" AND "personality." Inclusion criteria required full-text, peer-reviewed articles published in English and the use of standardised personality assessment tools. Studies were categorised according to whether DED was clinically confirmed or based on self-reported symptoms. Methodological quality was appraised using the NIH Study Quality Assessment Tools. The review protocol was registered in PROSPERO (CRD420251231024). This is a provisional file, not the final typeset article Results: A total of 408 records were identified, and 8 studies met the inclusion criteria. Four studies involved clinically confirmed diagnoses of DED, while four relied on self-reported symptom measures. Across both groups, personality traits, particularly neuroticism and harm avoidance, were associated with greater symptom burden and reduced quality of life. Regression and mediation analyses in several studies supported the influence of personality on symptom perception. Conclusion: The findings suggest that personality traits contribute to the subjective experience and clinical impact of DED. However, the predominance of cross-sectional designs and reliance on self-reported measures limit causal interpretation. Further longitudinal and multimethod research is needed to clarify the underlying mechanisms and inform integrated clinical approaches that address both ocular and psychological aspects of DED.
Summary
Keywords
clinical psychology, DED, Dry eye disease, Ophthalmology, Personality, personality traits
Received
27 December 2025
Accepted
20 February 2026
Copyright
© 2026 Meduri, Merlo, Sparacino, De Luca, Mancini, Oliverio, Palino, Silvestro, Martino and Aragona. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Emanuele Maria Merlo
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