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(147) Ocular pain is associated with dry eye symptoms

      Dry eye is a heterogeneous condition whose signs have been defined as disturbances of tear function, abnormalities of the ocular surface, and symptoms including visual disturbances and discomfort, although discrepancies between signs and symptoms have caused difficulty for diagnosis and treatment. Prevalence estimates for dry eye range from 5% to over 35%, and dry eye has been shown to have a significant impact on quality of life. Although ocular pain has been suggested as a key component of dry eye for at least a subgroup of patients, the characterization of this type of pain, and its relationship to traditional symptoms of dry eye, has not previously been systematically investigated. Given a recent large twin study, showing that dry eye likely shares genetic factors and a common etiological pathway with other chronic pain syndromes, identifying and describing the pain component of dry eye may provide a new avenue for defining and linking signs and symptoms of this condition. The primary purpose of the present study, therefore, was to evaluate whether the prevalence, severity, and quality of eye pain is associated with the severity of symptoms traditionally associated with dry eye. Seventy-six of 102 male veteran subjects (74.5%) were found to have mild-to-severe dry eye symptoms, and 86.8% of those with dry eye symptoms also reported ocular pain (pain intensity 3.86±2.35 (0-10 numerical rating scale)), compared to 7.7% of those without dry eye symptoms (0.15±0.54; p < 0.001). The most frequently reported qualities from the Short-Form McGill Pain Questionnaire that were chosen by dry eye subjects to describe their ocular pain were: “hot-burning” (28.9%), “aching” (19.7%), “tender” (19.7%), and “tiring-exhausting” (19.7%). Results indicate that ocular pain is a clinically important symptom of dry eye and that this pain may have neuropathic-like components in a subset of those with a dry eye diagnosis.