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Juana Gallar, Celia Morales, Vanesa Freire, M. Carmen Acosta, Carlos Belmonte, Juan A. Duran; Decreased Corneal Sensitivity and Tear Production in Fibromyalgia. Invest. Ophthalmol. Vis. Sci. 2009;50(9):4129-4134. doi: 10.1167/iovs.08-3083.
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purpose. To investigate corneal sensitivity to selective mechanical, chemical, heat, and cold stimulation in patients with fibromyalgia (FM).
methods. Twenty patients with FM (18 women, 2 men; 51.9 ± 2.3 years old) and 18 control subjects (16 women, 2 men; 51.7 ± 2.4 years) participated voluntarily in the study. Subjective symptoms of ocular dryness were explored and a Schirmer I test was performed. The response to selective stimulation of the central cornea with the Belmonte gas esthesiometer was measured.
results. The majority (18/20) of patients with FM reported dry eye symptoms, with the ocular dryness score significantly higher in affected subjects than in healthy ones (2.3 ± 0.1 vs. 0.05 ± 0.02; P < 0.001). The Schirmer test results were significantly lower in patients with FM than in those in the control group (10.5 ± 2.2 and 30.6 ± 1.6 mm, respectively; P < 0.001). Mean corneal threshold sensitivity values to chemical stimulation (31.16% ± 2.04% CO2 FM; 15.72% ± 0.67% CO2 control), heat (1.87 ± 0.11°C FM; 0.99 ± 0.05°C control), and cold (−2.53 ± 0.11°C FM; −0.76 ± 0.05°C control) were increased in patients with FM, whereas threshold responses to mechanical stimulation did not vary significantly (123.0 ± 8.0 mL/min FM; 107.8 ± 4.4 mL/min control).
conclusions. The reduced corneal sensitivity of patients with fibromyalgia is attributable to a moderate decrease in corneal polymodal and cold nociceptor sensitivity, which may be the consequence or the cause of the chronic reduction in tear secretion also observed in these patients.
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