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Dry eye symptoms align more closely to non-ocular conditions than to tear film parameters
  1. Anat Galor1,2,
  2. Elizabeth R Felix3,4,
  3. William Feuer2,
  4. Nabeel Shalabi1,2,
  5. Eden R Martin5,6,
  6. Todd P Margolis7,
  7. Constantine D Sarantopoulos1,8,
  8. Roy C Levitt1,6,7,8
  1. 1Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, Florida, USA
  2. 2Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
  3. 3Research service, Miami Veterans Administration Medical Center, Miami, Florida, USA
  4. 4Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA
  5. 5John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
  6. 6John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, Florida, USA
  7. 7Ophthalmology Department, Washington University School of Medicine, St. Louis, Missouri, USA
  8. 8Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, Florida, USA
  1. Correspondence to Dr Anat Galor, Bascom Palmer Eye Institute, University of Miami, 900 NW 17th Street, Miami, FL 33136, USA; agalor{at}med.miami.edu

Abstract

Objective To evaluate the relationship between dry eye symptoms, non-ocular conditions and tear film parameters.

Methods Design: Cross-sectional study. Participants/setting: The study population consisted of patients who were seen in the Miami Veterans Affairs eye clinic. Patients filled out standardised questionnaires assessing dry eye symptoms (dry eye questionnaire 5 (DEQ5) and ocular surface disease index (OSDI)), non-ocular pain, depression and post-traumatic stress disorder (PTSD), and also underwent measurement of tear film parameters. Main outcome measures: Correlations between dry eye symptoms and non-ocular conditions as compared with tear film parameters.

Results 136 patients with a mean age of 65 (SD 11) years participated in the study. All correlations between the dry eye questionnaire scores (DEQ5 and OSDI) and (A) self-reported non-ocular pain measures (numerical rating scale and pain history), (B) depression and (C) PTSD were significant and moderate in strength (Pearson's coefficient 0.24 to 0.60, p<0.01 for all). All correlations between the dry eye questionnaires and tear film measures were weak (Pearson's coefficient −0.10 to 0.18) and most were not significant. Multivariable linear regression analyses revealed that PTSD and non-ocular pain more closely associated with dry eye symptoms than did tear film parameters. Specifically, non-ocular pain and PTSD accounted for approximately 36% of the variability in DEQ5 scores (R=0.60) and approximately 40% of variability in OSDI scores (R=0.64). Of note, none of the tear parameters remained significantly associated with dry eye symptoms in either model.

Conclusions Dry eye symptoms more closely align to non-ocular pain, depression and PTSD than to tear film parameters.

  • Ocular surface

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