Aim: This study aims to explore the relationship between psychiatric symptoms and ocular surface microbiota diversity in contact lens wearers, focusing on whether psychiatric symptoms such as anxiety, depression, and somatization influence the microbial composition of the ocular surface. Materials and Methods: A cohort of 80 contact lens wearers aged 18 to 65 years was recruited from a tertiary care center. Participants were grouped based on the presence or absence of psychiatric symptoms, assessed using the DSM-5 criteria. Ocular surface samples were collected and analyzed for bacterial diversity using next-generation sequencing (NGS) of the 16S ribosomal RNA gene. The psychiatric symptoms were assessed using the Symptom Checklist-90 Revised (SCL-90-R). Statistical analysis included univariate and multivariate methods to assess the correlation between microbial diversity and psychiatric symptoms. Results: The group with psychiatric symptoms exhibited significantly higher rates of anxiety (70% vs. 10%), depression (62.5% vs. 7.5%), somatization (55% vs. 15%), and obsessive-compulsive symptoms (45% vs. 12.5%) compared to the group without psychiatric symptoms (p < 0.001). A significant reduction in microbial diversity was observed in the psychiatric symptom group (Shannon Diversity Index: 1.45 ± 0.22 vs. 1.76 ± 0.25, p < 0.001). Multiple regression analysis revealed significant negative correlations between microbial diversity and both anxiety (B = -0.29, p = 0.025) and depression (B = -0.24, p = 0.032). Conclusion: Psychiatric symptoms, particularly anxiety and depression, are significantly associated with reduced ocular surface microbiota diversity in contact lens wearers. While the prevalence of individual bacterial species did not differ significantly, the overall microbial diversity was notably affected. These findings suggest that psychological health may influence the ocular microbiome, potentially impacting ocular health.