July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Ocular Pain Response to Treatment in Dry Eye Patients
Author Affiliations & Notes
  • Andrew Nicolas Siedlecki
    Ophthalmology, Case Western Reserve University, Cleveland, Ohio, United States
    Ophthalmology, University Hospitals of Cleveland, Cleveland, Ohio, United States
  • Scott Smith
    Ophthalmology, Case Western Reserve University, Cleveland, Ohio, United States
    Ophthalmology, Cleveland Clinic, Abu Dhabi, United Arab Emirates
  • Rony R Sayegh
    Ophthalmology, Case Western Reserve University, Cleveland, Ohio, United States
    Ophthalmology, Cleveland Clinic, Abu Dhabi, United Arab Emirates
  • Footnotes
    Commercial Relationships   Andrew Siedlecki, None; Scott Smith, None; Rony Sayegh, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6745. doi:
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      Andrew Nicolas Siedlecki, Scott Smith, Rony R Sayegh; Ocular Pain Response to Treatment in Dry Eye Patients. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6745.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : An ocular pain component is frequently reported by patients with dry eye disease (DED). We evaluate the subjective effect of dry eye treatment on ocular pain in patients with DED.

Methods : Cross-sectional study of patients presenting with a chief complaint of dry eye. Demographics, past ocular and medical history, OSDI, numeric pain scale score, pain descriptors, and subjective response to each attempted dry eye treatment (“helped a lot”, “helped partially”, “did not help”) were collected between February and August 2018. Non-parametric tests were used to identify differential treatment response in patients with various pain levels.

Results : 144 patients were divided into 4 groups according to their pain level. Increasing pain was significantly associated with younger age and a higher OSDI score. There was no statistically significant trend between pain severity and gender, race, marital status, or history of cataract or refractive surgery. Patients with higher pain intensity ratings were more likely to report a history of fibromyalgia or depression (p=0.01) and less likely to exhibit punctate fluorescein staining of the cornea (p=0.009) or have symptomatic improvement with topical anesthetic (p=0.05). Pain in the high intensity group was more likely to be described as burning, constant, associated with sensitivity to light, itching, and body pain. A significantly lower proportion of severe pain patients reported improvement with artificial tears (70.7% vs. 86.5%, p=0.003), cyclosporine (30.4% vs. 60.5%, p=0.001), punctal occlusion (47.4% vs. 68.1%, p=0.05) and serum tears (54.5% vs 70.0%, p=0.05). There was no significant difference in reported improvement with ointment (71.9% vs. 54.2%), lifitegrast (56.8% vs. 25.0%), omega-3 (52.8% vs. 52.4%), tetracyclines (40.9% vs 40.0%), pain pills (47.4% vs 44.8%), opioids (29.2% vs 36.4%), gabapentinoids (29.2% vs 28.0%), antidepressants (21.7% vs 25.0%), hot compresses (86.9% vs 76.7%), sunglasses (78.5% vs 74.2%), and aerobic exercise (31.7% vs. 28.6%) in all patients versus the severe pain group.

Conclusions : Dry eye patients with severe ocular pain often have associated psychological and systemic pain conditions. Cross-sectional studies can provide guidance in the treatment of patients with dry eye-related ocular pain and guide future prospective studies on potentially effective therapies.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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