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    How chronic pain syndromes and dry eye are correlated

    A central disorder may be the cause of high ocular pain scores

    Take-home message: Patients with chronic pain syndromes report worse dye eye symptoms and ocular and non-ocular pain scores, which might indicate the presence of a central pain disorder as an underlying mechanism in both conditions.

    Miami—There appears to be an association between chronic pain syndromes, mental health, and dry eye, which, according to the researchers who identified this link, might indicate a central pain disorder.

    If this is the case, a new approach is needed for diagnosis and treatment of these patients to improve patient outcomes.

    In their recent publication in The Journal of Pain (2015; Dec 1.epub), investigators led by Anat Galor, MD, MSPH, explained that recent research has shown “that dry eye susceptibility and other chronic pain syndromes such as chronic widespread pain, irritable bowel syndrome, and pelvic pain, might share common heritable factors.”

    In their previous studies, this group from the Miami VAMC and Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, where Dr. Galor is associate professor of clinical ophthalmology, found that eye pain in many patients with dry eye closely resembled that of other chronic pain syndromes, such as spontaneous burning pain, hyperalgesia, and allodynia (which in the eye manifest as wind- and light-evoked pain).

    These specific eye pain symptoms are associated with a more severe and chronic dry eye course that is less responsive to topical therapy with artificial tears.

    Because of this, Dr. Galor and senior investigator, Roy C. Levitt, MD, a neuroanesthesiologist and pain specialist, speculated that these patients might have a different dry eye phenotype in contrast to patients with fewer chronic pain syndromes. Dr. Levitt is professor and vice chairman, Translational Research and Academic Affairs, Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami.

    Drs. Galor and Levitt drew their study population from the Miami Veterans Affairs Hospital. The 154 study patients all had dry eye symptoms (a score on the Dry Eye Questionnaire 5 [DEQ5] of 6 or higher and normal eyelid and corneal anatomy).

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