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Possible Link Between Dry Eye Disease and Migraine

Older adults of both sexes may be at higher risk.

A PPM Brief

Recent research1 out of the University of North Carolina aimed to determine stronger evidence of a link between dry eye disease (DED) and migraine. DED, a multifactorial disorder of the tear film and ocular surface resulting in discomfort, visual disturbance, increased tear film osmolarity, and tear film instability, has an estimated prevalence of 7.4% to 33.7% in the United States.2 The disorder can lead to inflammation of the ocular surface and a low quality of life.

In a retrospective case-control study, researchers examined 72,969 patients (all older than 18 years) from University of North Carolina–affiliated ophthalmology clinics during the period of May 1, 2008 through May 31, 2018. The base population consisted of 41,764 men (57.2%) and 31,205 women (42.8%). Of the subjects, 5,352 (7.3%) had a migraine headache diagnosis and 9,638 (13.2%) had diagnosed DED.

The odds of having DED with a diagnosis of migraine headaches was 1.72 (95% CI, 1.60-1.85) times higher than that of patients without migraine headaches after adjusting for sex and age groups. After excluding individuals with confounding factors (eg, use of specific medications, a history of rheumatoid arthritis, Sjögren’s syndrome, lupus, or a history of cataract or refractive surgery) the odds of having DED given a diagnosis of migraine headaches was 1.42 (95% CI, 1.20-1.68) times higher than that of patients without migraine headaches among a patient population of 39,306 individuals.

Older adults of both sexes may be at higher risk. (Source: 123RF)

Not including the confounding factors, men between the ages of 55 to 64 and women across all age groups exhibited odds ratios (ORs) between migraine headaches and DED that suggested an association. After accounting for the confounding factors, men (OR, 1.96; 95% CI, 1.02-3.77) and women (OR, 2.47; 95% CI, 1.75-3.47) 65 years or older exhibited ORs suggesting an association.

The findings suggest that patients with migraine are more likely to have comorbid DED, although “the exact mechanism underlying the relationship between migraine headaches and DED is unclear,” the researchers wrote. “However, it is well established that underlying inflammatory processes play a significant role in the pathogenesis of both disorders.”

The researchers suggested that physicians caring for migraine patients should be aware that these patients may also be at risk for comorbid dry eye disorder.

Last updated on: May 28, 2019
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