Ophthalmologists have recommended that eye care professionals treat people with dry eye disease (DED) holistically following the release of results from a study that found DED sufferers have higher pain sensitivity and pain intolerance.
In their research, which was reported in JAMA Ophthalmology (August 2013), investigators administered the heat pain threshold (HPT) and heat pain suprathreshold (HPST) tests on 1,635 healthy women. They placed a probe on the forearm of each woman and slowly increased the heat delivered until participants hit a button to signify pain changed from hot to painful. Tests were repeated on the opposite forearm, and maximal tolerated temperatures were recorded. Both tests started at 32° but differed in incremental increases in temperature.
Women who reported ocular pain symptoms on the Ocular Surface Disease Index questionnaire were significantly more likely to have high pain sensitivity compared with women who did not report ocular pain symptoms. Additionally, participants with a high pain sensitivity were approximately 75 per cent more likely to report DED pain symptoms compared with those with a low pain sensitivity.
“Our results indicate that [a subset of] persons with DED might be more sensitive to pain,” lead study author, Professor Jelle Vehof, from the Department of Ophthalmology and Epidemiology at the University Medical Center Groningen, the Netherlands reported.
“Physicians need to keep this in mind when investigating and managing patients with dry eye. Consider the holistic picture, rather than focusing on ocular signs only.”
Dr. Ivan R. Schwab, from the American Academy of Ophthalmology said, “It is important to realise that to the patient these symptoms are annoying or even disabling whether they have increased pain sensitivity or not. In other words, the increased pain sensation is part of the disease and still deserves attention.”