Dry Eye Linked to Chronic Pain Syndromes

Researchers have found a link between dry eye and chronic pain syndromes — a finding that suggests that a new paradigm is needed for diagnosis and treatment to improve patient outcomes.

“Our study indicates that some patients with dry eye have corneal somatosensory pathway dysfunction and would be better described as having neuropathic ocular pain,” said lead author Anat Galor, MD, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.

For the study, published in the Journal of Pain, the researchers evaluated 154 patients with dry eye from the Miami Veterans Affairs Hospital.

“Patients in our study with dry eye reported higher levels of ocular and non-ocular pain associated with multiple chronic pain syndromes, and had lower scores on depression and quality-of-life indices consistent with a central sensitivity disorder,” said co-author Roy C. Levitt, MD, University of Miami Miller School of Medicine.

“We also suspect that neuropathic ocular pain may share causal genetic factors with other overlapping chronic pain conditions,” he added.

Left untreated, dry eye can lead to inflammation, ulcers or scars on the cornea.

“Patients’ eyes may become hyper-sensitive to stimuli, such as wind or light, or have spontaneous pain such as a feeling of burning, which is typically associated with nerve injury,” said Dr. Levitt.

“Traditionally, eye specialists have treated dry eye with artificial tears or topical medications for the surface of the cornea,” noted Dr. Galor. “However, even if these treatments improve some dry eye symptoms, many patients continue to report underlying ocular and non-ocular pain.”

“Our highest priority is educating physicians that dry eye represents an overlapping chronic pain condition,” said Dr. Galor. “Consequently, a multidisciplinary approach should be considered in the diagnosis and pain management of patients with dry eye.”