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Pain-sensitive patients may report dry eye symptoms without pathology

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DENVER – Pain sensitivity influences ocular discomfort and dryness perception, according to a speaker here at the American Academy of Optometry meeting.

Wong Li, OD, FAAO, said that discrepancy between signs and symptoms of ocular discomfort as well as the fact that clinical tests for dry eye are poor predictors for symptom levels led to the study.

Li and colleagues analyzed whether participants’ Pain Sensitivity Questionnaire (PSQ) scores were associated with the results of their Ocular Surface Disease Index (OSDI) questionnaire.

"Our hypothesis is that individuals with greater sensitivity to pain or those with a higher PSQ score would be associated with noticing an increased perception of ocular discomfort," Li said.

Participants completed both the PSQ and OSDI questionnaire and then wore contact lenses and reported their experiences, Li detailed.

The 153 participants wore one inverted contact lens and one normally oriented contact lens for 30 minutes to induce dryness and discomfort, he said. Participants detailed their comfort and dryness using a visual analog scale every 5 minutes.

Li noted in his presentation that the fit of the lenses was the only difference between the two contacts.

Results showed a significant association between a high PSQ score and a high OSDI score.

In his presentation, Li explained the importance of the study and how it could help in shaping patient care and further studies.

“The individual’s psychology, specifically their pain sensitivity on how it affects their perception of ocular discomfort is a poorly understood topic,” he explained. “The inherent difficulty of measuring pain sensitivity has served as a barrier to understanding this. I think this study suggests that the PSQ may provide us a way to understand it using an easy-to-administer questionnaire and may help explain the disparity between the signs and symptoms of ocular discomfort. Specifically, on why clinical science is such a poor predictor for ocular discomfort. Understanding this relationship, of why signs are a poor indicator of ocular discomfort, in context with pain sensitivity, will guide future studies in terms of understanding ocular discomfort and contacts to dry eyes and contact lens discomfort.” – by Chelsea Frajerman

Disclosure: The authors have no relevant financial disclosures.