Anat Galor1, Leonid Zlotcavitch2, Scott D Walter1, Elizabeth R Felix3, William Feuer2, Eden R Martin4, Todd P Margolis5, Konstantinos D Sarantopoulos6, Roy C Levitt7. 1. Miami Veterans Administration Medical Center, Miami, Florida, USA Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA. 2. Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA. 3. Miami Veterans Administration Medical Center, Miami, Florida, USA Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida, USA. 4. John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, Florida, USA. 5. Departement of Ophthalmology, Washington University School of Medicine, St Louis, Missouri, USA. 6. Miami Veterans Administration Medical Center, Miami, Florida, USA Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, Florida, USA. 7. Miami Veterans Administration Medical Center, Miami, Florida, USA John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, Florida, USA Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, Florida, USA.
Abstract
OBJECTIVE: Studies of patients with non-ocular pain suggest that it is therapeutically useful to identify those with features of neuropathic pain. No data is available, however, on whether this approach has similar utility in dry eye. The purpose of this study was to determine whether severity and persistence of dry eye symptoms associate with self-reported symptoms of neuropathic ocular pain (NOP). DESIGN: Cohort study. PARTICIPANTS/ SETTING: 102 men seen in the Miami Veterans Affairs eye clinic. A baseline evaluation was performed consisting of the dry eye questionnaire 5 (DEQ5) and ocular surface evaluation. Patients were contacted ≥2 years later to repeat the DEQ5 and complete questionnaires that further characterised their eye pain. MAIN OUTCOME MEASURE: The relationship between dry eye symptom severity and persistence (DEQ5) and additional measures of ocular pain (NOP). RESULTS: Of 102 patients with variable dry eye symptoms, 70 reported at least mild symptoms on both encounters (DEQ5≥6). Fifty-four of 70 (77%) reported ≥1 NOP feature, and the number of NOP features correlated moderately with dry eye symptoms at both encounters (r=0.31-0.46, p<0.01). Patients with any symptom of NOP had higher dry eye symptom scores at both encounters (p<0.05), but similar ocular surface parameters. Hypersensitivity to wind and photoallodynia were associated with having mild or greater symptoms on both encounters (OR 3.4, 95% CI 1.2 to 10.0, p=0.02; OR 15.6, 95% CI 2.0 to 123, p=0.009, respectively). CONCLUSIONS: NOP features are common in patients with symptomatic dry eye and these features correlate with symptom severity and persistence. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVE: Studies of patients with non-ocular pain suggest that it is therapeutically useful to identify those with features of neuropathic pain. No data is available, however, on whether this approach has similar utility in dry eye. The purpose of this study was to determine whether severity and persistence of dry eye symptoms associate with self-reported symptoms of neuropathic ocular pain (NOP). DESIGN: Cohort study. PARTICIPANTS/ SETTING: 102 men seen in the Miami Veterans Affairs eye clinic. A baseline evaluation was performed consisting of the dry eye questionnaire 5 (DEQ5) and ocular surface evaluation. Patients were contacted ≥2 years later to repeat the DEQ5 and complete questionnaires that further characterised their eye pain. MAIN OUTCOME MEASURE: The relationship between dry eye symptom severity and persistence (DEQ5) and additional measures of ocular pain (NOP). RESULTS: Of 102 patients with variable dry eye symptoms, 70 reported at least mild symptoms on both encounters (DEQ5≥6). Fifty-four of 70 (77%) reported ≥1 NOP feature, and the number of NOP features correlated moderately with dry eye symptoms at both encounters (r=0.31-0.46, p<0.01). Patients with any symptom of NOP had higher dry eye symptom scores at both encounters (p<0.05), but similar ocular surface parameters. Hypersensitivity to wind and photoallodynia were associated with having mild or greater symptoms on both encounters (OR 3.4, 95% CI 1.2 to 10.0, p=0.02; OR 15.6, 95% CI 2.0 to 123, p=0.009, respectively). CONCLUSIONS: NOP features are common in patients with symptomatic dry eye and these features correlate with symptom severity and persistence. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Wan Chen; Hatim Ismail M Batawi; Jimmy R Alava; Anat Galor; Jin Yuan; Constantine D Sarantopoulos; Allison L McClellan; William J Feuer; Roy C Levitt; Jianhua Wang Journal: Ocul Surf Date: 2016-12-29 Impact factor: 5.033
Authors: Jerry P Kalangara; Anat Galor; Roy C Levitt; Derek B Covington; Katherine T McManus; Constantine D Sarantopoulos; Elizabeth R Felix Journal: Eye Contact Lens Date: 2017-05 Impact factor: 2.018
Authors: Ashley M Crane; Roy C Levitt; Elizabeth R Felix; Konstantinos D Sarantopoulos; Allison L McClellan; Anat Galor Journal: Br J Ophthalmol Date: 2016-04-29 Impact factor: 4.638
Authors: Nicole L Lanza; Allison L McClellan; Hatim Batawi; Elizabeth R Felix; Konstantinos D Sarantopoulos; Roy C Levitt; Anat Galor Journal: Ocul Surf Date: 2016-01-22 Impact factor: 5.033
Authors: Anat Galor; Derek Covington; Alexandra E Levitt; Katherine T McManus; Benjamin Seiden; Elizabeth R Felix; Jerry Kalangara; William Feuer; Dennis J Patin; Eden R Martin; Konstantinos D Sarantopoulos; Roy C Levitt Journal: J Pain Date: 2015-12-01 Impact factor: 5.820