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Incomplete response to artificial tears is associated with features of neuropathic ocular pain
  1. Anat Galor1,2,
  2. Hatim Batawi1,2,
  3. Elizabeth R Felix1,3,
  4. Todd P Margolis4,
  5. Konstantinos D Sarantopoulos1,5,
  6. Eden R Martin6,7,
  7. Roy C Levitt1,5,6,7
  1. 1Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, Florida, USA
  2. 2Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
  3. 3Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida, USA
  4. 4Departement of Ophthalmology, Washington University School of Medicine, St Louis, Missouri, USA
  5. 5Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, Florida, USA
  6. 6John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
  7. 7John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, Florida, USA
  1. Correspondence to Dr Anat Galor, Miami Veterans Administration Medical Center, 1201 NW 16th Street, Miami, FL 33125, USA; agalor{at}med.miami.edu

Abstract

Aims Artificial tears are first-line therapy for patients with dry eye symptoms. It is not known, however, which patient factors associate with a positive response to therapy. The purpose of this study was to evaluate whether certain ocular and systemic findings are associated with a differential subjective response to artificial tears.

Methods Cross-sectional study of 118 individuals reporting artificial tears use (hypromellose 0.4%) to treat dry eye-associated ocular pain. An evaluation was performed to assess dry eye symptoms (via the dry eye questionnaire 5 and ocular surface disease index), ocular and systemic (non-ocular) pain complaints and ocular signs (tear osmolarity, tear breakup time, corneal staining, Schirmer testing with anaesthesia, and eyelid and meibomian gland assessment). The main outcome measures were factors associated with differential subjective response to artificial tears.

Results By self-report, 23 patients reported no improvement, 73 partial improvement and 22 complete improvement in ocular pain with artificial tears. Patients who reported no or partial improvement in pain with artificial tears reported higher levels of hot-burning ocular pain and sensitivity to wind compared with those with complete improvement. Patients were also asked to rate the intensity of systemic pain elsewhere in the body (other than the eye). Patients who reported no or incomplete improvement with artificial tears had higher systemic pain scores compared with those with complete improvement.

Conclusions Both ocular and systemic (non-ocular) pain complaints are associated with a differential subjective response to artificial tears.

  • Ocular surface
  • Epidemiology
  • Treatment Medical

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