The Relationship Between Ocular Itch, Ocular Pain, and Dry Eye Symptoms (An American Ophthalmological Society Thesis)

• Published in: Transactions of the American Ophthalmological Society Vol. 115; p. T5
• Main Authors: Galor, Anat, Small, Leslie, Feuer, William, Levitt, Roy C, Sarantopoulos, Konstantinos D, Yosipovitch, Gil
• Format: Journal Article
• Language: English
• Published: United States The American Ophthalmological Society 01.08.2017
• Subjects: Cornea - physiology; Cross-Sectional Studies; Dry Eye Syndromes - diagnosis; Dry Eye Syndromes - physiopathology; Eye Diseases - diagnosis; Eye Diseases - physiopathology; Eye Pain - diagnosis; Eye Pain - physiopathology; Female; Humans; Male; Middle Aged; Ophthalmology - organization & administration; Pain Measurement; Pruritus - diagnosis; Pruritus - physiopathology; Quality of Life; Skin Physiological Phenomena; Societies, Medical; Surveys and Questionnaires; Tears - physiology; United States; Veterans
• ISSN: 0065-9533; 1545-6110

To evaluate associations between sensations of ocular itch and dry eye (DE) symptoms, including ocular pain, and DE signs. A cross-sectional study of 324 patients seen in the Miami Veterans Affairs eye clinic was performed. The evaluation consisted of questionnaires regarding ocular itch, DE symptoms, descriptors of neuropathic-like ocular pain (NOP), and evoked pain sensitivity testing on the forehead and forearm, followed by a comprehensive ocular surface examination including corneal mechanical sensitivity testing. Analyses were performed to examine for differences between those with and without subjective complaints of ocular itch. The mean age was 62 years with 92% being male. Symptoms of DE and NOP were more frequent in patients with moderate-severe ocular itch compared to those with no or mild ocular itch symptoms. With the exception of ocular surface inflammation (abnormal matrix metalloproteinase 9 testing) which was less common in those with moderate-severe ocular itch symptoms, DE signs were not related to ocular itch. Individuals with moderate-severe ocular itch also demonstrated greater sensitivity to evoked pain on the forearm and had higher non-ocular pain, depression, and post-traumatic stress disorders scores, compared to those with no or mild itch symptoms. Subjects with moderate-severe ocular itch symptoms have more severe symptoms of DE, NOP, non-ocular pain and demonstrate abnormal somatosensory testing in the form of increased sensitivity to evoked pain at a site remote from the eye, consistent with generalized hypersensitivity.