Neuropathic Ocular Pain due to Dry Eye Is Associated With Multiple Comorbid Chronic Pain Syndromes

Anat Galor, Derek Covington, Alexandra E. Levitt, Katherine T. McManus, Benjamin Seiden, Elizabeth R. Felix, Jerry Kalangara, William J Feuer, Dennis J. Patin, Eden R. Martin, Konstantinos D. Sarantopoulos, Roy C. Levitt

Research output: Contribution to journalArticle

38 Scopus citations


Recent data show that dry eye (DE) susceptibility and other chronic pain syndromes (CPS) such as chronic widespread pain, irritable bowel syndrome, and pelvic pain, might share common heritable factors. Previously, we showed that DE patients described more severe symptoms and tended to report features of neuropathic ocular pain (NOP). We hypothesized that patients with a greater number of CPS would have a different DE phenotype compared with those with fewer CPS. We recruited a cohort of 154 DE patients from the Miami Veterans Affairs Hospital and defined high and low CPS groups using cluster analysis. In addition to worse nonocular pain complaints and higher post-traumatic stress disorder and depression scores (P <.01), we found that the high CPS group reported more severe neuropathic type DE symptoms compared with the low CPS group, including worse ocular pain assessed via 3 different pain scales (P <.05), with similar objective corneal DE signs. To our knowledge, this was the first study to show that DE patients who manifest a greater number of comorbid CPS reported more severe DE symptoms and features of NOP. These findings provided further evidence that NOP might represent a central pain disorder, and that shared mechanistic factors might underlie vulnerability to some forms of DE and other comorbid CPS. Perspective: DE patients reported more frequent CPS (high CPS group) and reported worse DE symptoms and ocular and nonocular pain scores. The high CPS group reported symptoms of NOP that share causal genetic factors with comorbid CPS. These results imply that an NOP evaluation and treatment should be considered for DE patients.

Original languageEnglish (US)
JournalJournal of Pain
StateAccepted/In press - Aug 10 2015


  • Allodynia
  • Central pain syndromes
  • Chronic overlapping pain syndromes
  • Chronic pain
  • Comorbid pain syndromes
  • Dry eye symptoms
  • Hyperalgesia
  • Neuropathic ocular pain
  • Neuropathic pain

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Neurology
  • Clinical Neurology

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