Integrated management of dry eye–depression comorbidity: mechanistic insights and temporal therapeutic strategies

The frequent co-occurrence of dry eye disease (DED) and depressive disorder imposes a significant dual burden on patient quality of life and healthcare systems. Current fragmented, discipline-specific care models remain inadequate for addressing this clinical reality. The core challenge lies in the absence of integrated management frameworks for comorbid presentations, with particular neglect of treatment sequencing that often compromises therapeutic outcomes. This perspective article proposes that effective management of DED-depression comorbidity should build upon shared pathophysiological mechanisms—including neurogenic inflammation and eye-brain axis dysfunction—to construct an integrated mind–body therapeutic paradigm. We present a comprehensive framework encompassing stratified phenotypic assessment, a stepwise therapeutic ladder, and a dynamic temporal optimization strategy guided by bidirectional biological and psychological interactions. This integrated paradigm holds promise for transcending disciplinary boundaries, enabling precision treatment selection, and ultimately improving long-term patient outcomes through holistic, patient-centered care.