• Jerry P Kalangara, Anat Galor, Roy C Levitt, Derek B Covington, Katherine T McManus, Constantine D Sarantopoulos, and Elizabeth R Felix.
• Department of Anesthesiology (J.P.K., R.C.L., D.B.C., C.D.S.), Perioperative Medicine and Pain Management, University of Miami, Miller School of Medicine, Miami, FL; Surgical Services (A.G.), Anesthesia Service (R.C.L., C.D.S.), Research Service (K.T.M., E.R.F.), Miami Veterans Affairs Medical Center, Miami, FL; Bascom Palmer Eye Institute (A.G.), University of Miami, Miami, FL; John P. Hussman Institute for Human Genomics (R.C.L.), University of Miami, Miller School of Medicine, Miami, FL; John T. Macdonald Foundation Department of Human Genetics (R.C.L.), University of Miami, Miller School of Medicine, Miami, FL; and Department of Physical Medicine and Rehabilitation (E.R.F.), University of Miami, Miller School of Medicine, Miami, FL.
• Eye Contact Lens. 2017 May 1; 43 (3): 192-198.

ObjectiveThe purpose of this study was to examine the severity and quality of ocular pain complaints in patients with dry eye symptoms.MethodsSubjects with clinically relevant dry eye symptoms (dryness, discomfort, tearing) of unknown origin seen in the Miami Veterans Affairs eye clinic were administered questionnaires for dry eye symptoms and ocular pain and underwent a standardized ocular examination. Qualities and severity ratings of ocular pain in subjects with idiopathic dry eye were compared with similar measures from published data in other chronic pain populations.ResultsThe study sample consisted of 154 subjects, of which 91% were men and ranged in age from 27 to 89 (mean age=61). Fifty-three percent of participants reported an average ocular pain of at least moderate intensity (numerical rating scale≥4), with specific characteristics (i.e., "burning" spontaneous pain) reported at frequencies comparable to prevalent chronic neuropathic pain syndromes as reported in the literature. Significant correlations were found between ocular pain metrics and dry eye symptom severity scores (r=0.57-0.66). Dry eye signs, however, did not generally correlate with ocular pain severity.ConclusionsA significant proportion of subjects with idiopathic dry eye symptoms reported moderate or greater ocular pain intensity, with most endorsing descriptors commonly used by patients with nonocular neuropathic pain conditions. Identifying subgroups of dry eye patients based on the presence and characteristics of ocular pain complaints may improve dry eye subclassification and better individualize treatment strategies.

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