Dry eye patients with severe ocular pain often have associated psychological and systemic pain conditions, a study in The Ocular Surface suggests. And while treating the underlying dry eye symptoms can help reduce ocular discomfort, the study’s participants still had a low rate of satisfaction, which highlights the need for more effective therapies, the researchers noted. 

The study enrolled 144 patients who presented for dry eye management. The researchers considered factors like demographics, ocular and medical history, ocular surface disease index (OSDI) scores, numeric pain scale results, pain descriptors, subjective response to eye drops and systemic and non-pharmacologic treatments.

The participants were categorized into four groups based on their reported pain severity. Researchers found increased pain was linked to younger age, history of refractive surgery, higher OSDI scores and less likelihood of corneal staining. Patients with higher pain intensity were more inclined to report a history of fibromyalgia, depression, anxiety and migraine.

Also of note: patients with greater pain severity were less responsive to treatment, including artificial tears, lubricating ointment, steroid eye drops, cyclosporine 0.05%, 20% autologous serum tears, hot compresses, lid hygiene and punctal plugs.

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, the researchers noted.

Siedlecki AN, Smith SD, Siedlecki AR, et al. Ocular pain response to treatment in dry eye patients. Ocul Surf. January 10, 2020. [Epub ahead of print].