• Victoria S Chang, Terri P Rose, Carol L Karp, Roy C Levitt, Constantine Sarantopoulos, and Anat Galor.
• Department of Ophthalmology (V.S.C., T.P.R., C.L.K., A.G.), Bascom Palmer Eye Institute, University of Miami, Miami, FL; Department of Ophthalmology (R.C.L., A.G.), Miami Veteran Affairs Medical Center; Department of Anesthesiology, Perioperative Medicine and Pain Management (R.C.L., C.S.), Miller School of Medicine, University of Miami, Miami, FL; John P. Hussman Institute for Human Genomics (R.C.L.), Miller School of Medicine, University of Miami, Miami, FL; and John T. Macdonald Foundation Department of Human Genetics (R.C.L.), Miller School of Medicine, University of Miami, Miami, FL.
• Eye Contact Lens. 2018 Nov 1; 44 Suppl 2: S307-S313.

ObjectiveTo evaluate the association between dry eye (DE) symptoms and neuropathic-like ocular pain (NOP) features, chronic pain conditions, depression, and anxiety in patients presenting for routine ophthalmic examinations.MethodsTwo hundred thirty-three consecutive patients ≥18 years of age presenting to a comprehensive eye clinic between January and August 2016 were included in this study. Information on demographics, chronic pain conditions, medication use, DE symptoms (dry eye questionnaire, DEQ5), NOP complaints (burning; wind, light, and temperature sensitivity), depression, and anxiety indices (patient health questionnaire 9, PHQ-9 and symptom checklist 90-revised, SCL-90-R) were collected for each individual. Pearson correlation was used to evaluate strengths of association. Logistic regression analysis examined risk factors for any (DEQ5≥6) and severe (DEQ5≥12) DE symptoms.ResultsThe mean age of the population was 46.3 years (±13.0); 67.8% (n=158) were female. Per the DEQ5, 40.3% (n=94) had mild or greater DE symptoms and 12% (n=24) had severe symptoms. Severity of DE symptoms correlated with NOP complaints: burning (Pearson r=0.37, P<0.001); sensitivity to wind (r=0.37, P<0.001), sensitivity to light (r=0.34, P<0.001), and sensitivity to temperature (r=0.30, P<0.001). Sex, race, and ethnicity were not significant risk factors for DE symptoms. Risk factors for mild or greater DE symptoms included a greater number of chronic nonocular pain conditions (odds ratio [OR]=1.38, P<0.001), arthritic pain (OR=6.34, P<0.001), back pain (OR=2.47, P=0.004), headaches (OR=2.14, P=0.02), depression (OR=1.17, P<0.001), and anxiety (OR=1.13, P=0.02).ConclusionDry eye severity positively associated with NOP complaints, comorbid chronic pain conditions, and symptoms of depression and anxiety.

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