title: The impact of dysfunctional tear films and optical aberrations on chronic migraine.
abstract: BACKGROUND
  Migraine is a multifactorial disorder with complex neuronal and vascular mechanisms that encompasses a wide clinical spectrum of symptoms, including ocular manifestations. Dry eye disease and dysfunction of ocular somatosensory pathways have been implicated in the pathogenesis. The current study investigates the association between a dysfunctional tear film and ocular aberrations with migraine.
  
  
  METHODS
  Sixty eyes of 30 patients with migraine and 60 eyes of 30 controls were studied. Dry eye evaluation included Schirmer's test, tear film break-up time, corneal esthesiometry and lipid layer analysis using Lipiview® interferometer. Wavefront aberrations were measured using Optical Path Difference before performing the dry eye evaluation. The intraocular light scatter was quantified using the objective scatter index (OSI) of the optical quality analysis system. Measured parameters were compared between the migraine and the control group using independent samplet-test. Statistical analysis was performed using commercial software. Apvalue of ≤ 0.05 was considered statistically significant.
  
  
  RESULTS
  There were 19 females and 11 males in each group. Statistically significant difference was found between the two groups with respect to total aberrations (p= 0.049), higher order aberrations (p= 0.009), coma (p= 0.03), spherical aberrations (p= 0.018), Lipiview interferometric coloric units (p< 0.001) and OSI (p< 0.001). Trefoil (p= 0.26) and TBUT (p= 0.398) were not significantly different between both groups.
  
  
  CONCLUSIONS
  Ocular aberrations are higher in patients with migraine as compared with controls. Tear film abnormalities add to the aberrations in otherwise asymptomatic patients and may also be associated with migraineous attacks. Treating the ocular surface to obtain a healthy tear film might introduce a potential modifiable factor in the prevention of migraneous attacks.
authors.affiliation: Department of Ophthalmology, Narayana Nethralaya Eye Institute, 121/C, Chord Road, 1 "R" Block, Rajajinagar, Bangalore, 560010 Karnataka India.
authors.forename: Rohit
authors.initials: R
authors.lastname: Shetty
authors.affiliation: Department of Ophthalmology, Narayana Nethralaya Eye Institute, 121/C, Chord Road, 1 "R" Block, Rajajinagar, Bangalore, 560010 Karnataka India.
authors.forename: Kalyani
authors.initials: K
authors.lastname: Deshpande
authors.affiliation: Department of Ophthalmology, Narayana Nethralaya Eye Institute, 121/C, Chord Road, 1 "R" Block, Rajajinagar, Bangalore, 560010 Karnataka India.
authors.forename: Chaitra
authors.initials: C
authors.lastname: Jayadev
authors.affiliation: Department of Ophthalmology, Narayana Nethralaya Eye Institute, 121/C, Chord Road, 1 "R" Block, Rajajinagar, Bangalore, 560010 Karnataka India.
authors.forename: Kareeshma
authors.initials: K
authors.lastname: Wadia
authors.affiliation: Department of Ophthalmology, Narayana Nethralaya Eye Institute, 121/C, Chord Road, 1 "R" Block, Rajajinagar, Bangalore, 560010 Karnataka India.
authors.forename: Pooja
authors.initials: P
authors.lastname: Mehta
authors.affiliation: Department of Ophthalmology, Narayana Nethralaya Eye Institute, 121/C, Chord Road, 1 "R" Block, Rajajinagar, Bangalore, 560010 Karnataka India.
authors.forename: Rushad
authors.initials: R
authors.lastname: Shroff
authors.affiliation: Department of Ophthalmology, Narayana Nethralaya Eye Institute, 121/C, Chord Road, 1 "R" Block, Rajajinagar, Bangalore, 560010 Karnataka India.
authors.forename: Harsha L
authors.initials: HL
authors.lastname: Rao
keywords: Aberrations; Dry eye; Migraine