{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:24:26Z","timestamp":1787588666316,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OVS"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Dry eye disease is a multifactorial condition in which symptom burden may reflect ocular surface alterations together with broader psychophysiological processes. Previous studies have reported associations between dry eye symptoms and psychological distress, but most relied on cross\u2010sectional designs and could not clarify temporal directionality. This study examined the longitudinal association between perceived stress and dry eye symptoms using a two\u2010wave cross\u2010lagged panel design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010one young adults (60 females; mean age 22\u00a0\u00b1\u00a03\u00a0years) completed the Perceived Stress Scale\u201014 (PSS\u201014) and the Ocular Surface Disease Index (OSDI) at two time points approximately 7.5\u00a0months apart. The second assessment took place under conditions of heightened regional threat. Paired\u2010samples\n                      <jats:italic>t<\/jats:italic>\n                      tests, Pearson correlations, bootstrap confidence intervals, and cross\u2010lagged panel modeling were applied. The prespecified directional path from perceived stress at Time 1 to dry eye symptoms at Time 2 was evaluated using a one\u2010tailed test; all other significance tests were two\u2010tailed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both perceived stress and dry eye symptoms increased significantly over the approximately 7.5\u2010month follow\u2010up period. Perceived stress increased by 4.2 points,\n                      <jats:italic>t<\/jats:italic>\n                      (70)\u00a0=\u00a06.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001,\n                      <jats:italic>dz<\/jats:italic>\n                      \u00a0=\u00a00.74, and dry eye symptoms increased by 7.5 points,\n                      <jats:italic>t<\/jats:italic>\n                      (70)\u00a0=\u00a03.46,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001,\n                      <jats:italic>dz<\/jats:italic>\n                      \u00a0=\u00a00.41. Perceived stress and dry eye symptoms were positively associated within each wave and showed substantial rank\u2010order consistency across waves. In the cross\u2010lagged model, the prospective path from perceived stress at Time 1 to dry eye symptoms at Time 2 was small and positive (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a00.18) but did not reach the conventional two\u2010tailed significance threshold (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.084); it reached statistical significance only under the prespecified directional one\u2010tailed test (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.042). The reverse cross\u2010lagged path was small and not statistically significant (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a00.09).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings provide suggestive, but not confirmatory, evidence of a small prospective association between earlier perceived stress and later dry eye symptom burden in a sample of predominantly young adult women. However, the finding should be interpreted cautiously given the modest sample size, the two\u2010wave design, and its dependence on a directional one\u2010tailed test. Further longitudinal studies are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ovs2.70091","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:18:27Z","timestamp":1786076307000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The longitudinal association between perceived stress and dry eye symptoms: A cross\u2010lagged panel study"],"prefix":"10.1002","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7924-0610","authenticated-orcid":false,"given":"Reut","family":"Ifrah","sequence":"first","affiliation":[{"name":"Department of Optometry and Vision Science Jerusalem Multidisciplinary College  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liat","family":"Gantz","sequence":"additional","affiliation":[{"name":"Department of Optometry and Vision Science Jerusalem Multidisciplinary College  Jerusalem 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