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Individuals with migraine have a different dry eye symptom profile than individuals without migraine
  1. Monika Farhangi1,
  2. Ryan J Diel2,
  3. Dawn C Buse3,
  4. Amy Michelle Huang1,
  5. Roy C Levitt4,
  6. Constantine D Sarantopoulos4,
  7. Elizabeth R Felix5,6,
  8. Anat Galor1,6
  1. 1 Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
  2. 2 Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
  3. 3 Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
  4. 4 Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida, USA
  5. 5 Physical Medicine & Rehabilitation, University of Miami, Miami, Florida, USA
  6. 6 Miami Veterans Administration Medical Center, Miami, Florida, USA
  1. Correspondence to Dr Anat Galor, Ophthalmology, Miami VA medical center, Miami, FL 33136, USA; agalor{at}


Background Many individuals with migraine report symptoms of dry eye (DE). However, it is not known whether DE profiles are similar between individuals with and without migraine. To bridge this gap, we evaluated symptoms and signs of DE, including symptoms suggestive of nerve dysfunction, in a large group of individuals with DE symptoms, and compared profiles between individuals with migraine and those without migraine or headache.

Methods Prospective cross-sectional study of individuals with DE symptoms seen at the Miami VA.

Results Of 250 individuals, 31 met International Classification of Headache Disorders criteria for migraine based on a validated screen. Individuals with migraine were significantly younger (57 vs 62 years) and more likely to be female (26% vs 6%) than controls. Individuals with migraine had more severe DE symptoms and ocular pain compared with controls (mean Ocular Surface Disease Index 53.93 ± 21.76 vs 36.30 ± 22.90, p=0.0001; mean Neuropathic Pain Symptom Inventory modified for the Eye 39.39 ± 23.33 vs 21.86 ± 20.17, p=0.0001). The difference in symptom profile occurred despite similar ocular surface parameters between the groups.

Conclusions Individuals with migraine had a different DE symptom yet a similar DE sign profile when compared with controls without migraine. This suggests that DE symptoms in individuals with migraine may be driven by nerve dysfunction as opposed to ocular surface abnormalities.

  • ocular surface
  • epidemiology
  • tears

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  • Contributors All authors contributed to this manuscript: design and conduct of the study (MF, RJD, AG), collection (AG), management (MF), analysis (MF and AG), interpretation of data (DCB, AMH, MF, RJD, RCL, CDS, ERF and AG), preparation and review or approval of the manuscript (DCB, AMH, MF, RJD, RCL, CDS, ERF and AG).

  • Funding Supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Clinical Sciences Research EPID006-15S (Dr. Galor), R01EY026174 (Dr. Galor), NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant; NIH NIDCR RO1 DE022903 and R21 NS105880 (Dr. Levitt), the Department of Anesthesiology, Perioperative Medicine, and Pain Management, University of Miami Miller School of Medicine, Miami, FL, USA.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request.

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