title: Dry eye symptom severity and persistence are associated with symptoms of neuropathic pain.
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).
  
  
  METHODS
  
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Miami Veterans Administration Medical Center, Miami, Florida, USA Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.
authors.forename: Anat
authors.initials: A
authors.lastname: Galor
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.
authors.forename: Leonid
authors.initials: L
authors.lastname: Zlotcavitch
authors.affiliation: Miami Veterans Administration Medical Center, Miami, Florida, USA Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Walter
authors.affiliation: Miami Veterans Administration Medical Center, Miami, Florida, USA Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Felix
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.
authors.forename: William
authors.identifier: http://orcid.org/0000-0002-9442-3076
authors.initials: W
authors.lastname: Feuer
authors.affiliation: 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.
authors.forename: Eden R
authors.initials: ER
authors.lastname: Martin
authors.affiliation: Departement of Ophthalmology, Washington University School of Medicine, St Louis, Missouri, USA.
authors.forename: Todd P
authors.initials: TP
authors.lastname: Margolis
authors.affiliation: 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.
authors.forename: Konstantinos D
authors.initials: KD
authors.lastname: Sarantopoulos
authors.affiliation: 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.
authors.forename: Roy C
authors.initials: RC
authors.lastname: Levitt
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015352:Dry Eye Syndromes / Q000175:diagnosis*; D058447:Eye Pain / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis*; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires
keywords: Epidemiology; Ocular surface