Aim To investigate the association between dry eye symptoms and depression in an adult population. Methods In this population-based cross-sectional study, a random sample of 1957 subjects from the Beijing Eye Study was examined for dry eye disease (DED) in 2006. All patients completed an interviewer-assisted questionnaire on dry eye symptoms and underwent measurement of tear break-up time (TBUT), slit-lamp evaluation of corneal staining and meibomian gland dysfunction (MGD), and the Schirmer test. In 2011, 1456 subjects from this sample were evaluated for depression using a depression scale. The association between depression symptoms and dry eye clinical tests was evaluated. Results Definite depression was more prevalent in patients with DED than in subjects without DED (13.70.4% vs 8.6 +/- 0.3%, p=0.02). The depression score was correlated with dry eye symptoms (correlation coefficient r=0.07; p=0.013) but not with TBUT (p=0.18), the Schirmer test (p=0.37), corneal staining (p=0.30) and MGD evaluation (p=0.93). In multivariate regression analysis, the risk of definite depression remained significantly associated with dry eye symptoms (p=0.028) after adjusting for lower cognitive status (p=0.01), rural region of habitation (p=0.023) and lower body weight (p=0.05). Conclusions In an older population from Beijing, depression was associated with DED and in particular with dry eye symptoms.