scholarly journals Dysfunctional Coping Mechanisms Contribute to Dry Eye Symptoms

2019 ◽  
Vol 8 (6) ◽  
pp. 901 ◽  
Author(s):  
Sneh Patel ◽  
Elizabeth R Felix ◽  
Roy C Levitt ◽  
Constantine D. Sarantopoulos ◽  
Anat Galor
Keyword(s):  
Pain Intensity ◽  
Dry Eye ◽  
Ocular Surface ◽  
Pain Catastrophizing ◽  
Pain Severity ◽  
Separate Analysis ◽  
Coping Behaviors ◽  
Ocular Pain ◽  
Eye Pain ◽  
The Impact

Dysfunctional coping behaviors, such as catastrophizing, have been implicated in pain severity and chronicity across several pain disorders. However, the impact of dysfunctional coping has not been examined under the context of dry eye (DE). This study evaluates relationships between catastrophizing and measures of DE, including pain severity and pain-related daily interference. The population consisted of patients seen at Miami Veterans Affairs eye clinic between April 2016 and October 2017. Patients filled out standardized questionnaires assessing symptoms of DE and eye pain, non-ocular pain, mental health, coping behaviors (Pain Catastrophizing Scale, PCS), and pain-related daily interference as a perceived impact on quality of life (Multidimensional Pain Inventory, Interference Subscale, MPI-Interference), and all patients underwent an ocular surface examination. In total, 194 patients participated, with a mean age of 58.8 ± 9.6 years, the majority being male, non-Hispanic, and black. PCS (catastrophizing) was correlated with DE symptom severity, including Dry-Eye Questionnaire 5 (DEQ5; r = 0.41, p < 0.0005), Ocular Surface Disease Index (OSDI; r = 0.40, p < 0.0005), and neuropathic-like eye pain (Neuropathic Pain Symptom Inventory-Eye (NPSI-Eye; r = 0.48, p < 0.0005). Most tear metrics, on the other hand, did not correlate with PCS. Linear regressions showed that PCS, non-ocular pain intensity, and number of pain conditions were significant predictors of DEQ5 (overall DE symptoms), while PCS and non-ocular pain intensity were predictors of NPSI-Eye scores, as were insomnia scores and analgesic use. In a separate analysis, PCS and DE symptoms (OSDI) associated with pain-related interference (MPI-Interference) along with non-ocular pain intensity, post-traumatic stress disorder (PTSD), number of pain conditions, and non-Hispanic ethnicity. These findings suggest that catastrophizing is not significantly related to signs of DE, but is strongly associated to pain-related symptoms of DE and daily interference due to pain.

scholarly journals Topical TRPM8 Agonist for Relieving Neuropathic Ocular Pain in Patients with Dry Eye: A Pilot Study

2021 ◽  
Vol 10 (2) ◽  
pp. 250
Author(s):  
Hyeon Jeong Yoon ◽  
Jonghwa Kim ◽  
Jee Myung Yang ◽  
Edward T. Wei ◽  
Seong Jin Kim ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Pain Intensity ◽  
Dry Eye ◽  
Associated Factors ◽  
Treatment Result ◽  
Ocular Pain ◽  
Eye Pain ◽  
Validated Questionnaire

Background: Activation of TRPM8, a cold-sensing receptor located on the cornea and eyelid, has the potential to relieve the neuropathic ocular pain (NOP) in dry eye (DE) by inhibiting other aberrant nociceptive inputs. We aimed to investigate the effect of a topical TRPM8 agonist, cryosim-3 (C3), on relieving DE-associated NOP. Methods: We conducted a prospective pilot study of 15 patients with DE-associated NOP. These patients applied topical C3 to their eyelid, 4 times/day for 1 month. The patients underwent clinical examinations. They also completed the Ocular Pain Assessment Survey (OPAS), which is a validated questionnaire for NOP, at baseline, 1 week, and 1 month after treatment. Result: At 1 week, the OPAS scores of eye pain intensity, quality of life (driving/watching TV, general activity, sleep, and enjoying life/relations with other people), and associated factors (burning sensation, light sensitivity, and tearing) improved. The total OPAS scores of eye pain intensity, quality of life, and associated factors remained improved at 1 month. The Schirmer test scores also improved at 1 month. Conclusion: TRPM8 agonist (C3) could be a novel agent for treating patients with DE-associated NOP who are unresponsive to conventional treatments.

scholarly journals Dexamethasone-Loaded Nanostructured Lipid Carriers for the Treatment of Dry Eye Disease

Pharmaceutics ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 905
Author(s):  
Sangeeta Kumari ◽  
Madhuri Dandamudi ◽  
Sweta Rani ◽  
Elke Behaeghel ◽  
Gautam Behl ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Pilot Scale ◽  
Dry Eye Disease ◽  
Rapid Screening ◽  
Eye Disease ◽  
Topical Steroids ◽  
Nanostructured Lipid Carrier ◽  
The Impact ◽  
Ophthalmic Formulation

Dry eye disease (DED) or keratoconjunctivitis sicca is a chronic multifactorial disorder of the ocular surface caused by tear film dysfunction. Symptoms include dryness, irritation, discomfort and visual disturbance, and standard treatment includes the use of lubricants and topical steroids. Secondary inflammation plays a prominent role in the development and propagation of this debilitating condition. To address this we have investigated the pilot scale development of an innovative drug delivery system using a dexamethasone-encapsulated cholesterol-Labrafac™ lipophile nanostructured lipid carrier (NLC)-based ophthalmic formulation, which could be developed as an eye drop to treat DED and any associated acute exacerbations. After rapid screening of a range of laboratory scale pre-formulations, the chosen formulation was prepared at pilot scale with a particle size of 19.51 ± 0.5 nm, an encapsulation efficiency of 99.6 ± 0.5%, a PDI of 0.08, and an extended stability of 6 months at 4 °C. This potential ophthalmic formulation was observed to have high tolerability and internalization capacity for human corneal epithelial cells, with similar behavior demonstrated on ex vivo porcine cornea studies, suggesting suitable distribution on the ocular surface. Further, ELISA was used to study the impact of the pilot scale formulation on a range of inflammatory biomarkers. The most successful dexamethasone-loaded NLC showed a 5-fold reduction of TNF-α production over dexamethasone solution alone, with comparable results for MMP-9 and IL-6. The ease of formulation, scalability, performance and biomarker assays suggest that this NLC formulation could be a viable option for the topical treatment of DED.

scholarly journals Clinical Characteristics of Dry Eye with Ocular Neuropathic Pain Features: Comparison According to the Types of Sensitization Based on the Ocular Pain Assessment Survey

2020 ◽  
Author(s):  
Jonghwa Kim ◽  
Hyeon Jeong Yoon ◽  
In Cheon You ◽  
Byung Yi Ko ◽  
Kyung Chul Yoon
Keyword(s):  
Neuropathic Pain ◽  
Dry Eye ◽  
Ocular Surface ◽  
Clinical Characteristics ◽  
Tear Film ◽  
Meibomian Gland ◽  
Burning Sensation ◽  
Ocular Pain ◽  
Central Group ◽  
Assessment Survey

Abstract Background: To compare the clinical characteristics of dry eye patients with ocular neuropathic pain features according to the types of sensitization based on the Ocular Pain Assessment Survey (OPAS).Methods: Cross-sectional study of 33 patients with dry eye and ocular neuropathic pain features. All patients had a comprehensive ophthalmic assessment including detailed history, the intensity and duration of ocular pain, the tear film, ocular surface, and Meibomian gland examination, and OPAS. Patients with <50% improvement in pain intensity after proparacaine challenge test were assigned to the central-dominant sensitization group (central group) and those with ≥50% improvement were assigned to the peripheral-dominant sensitization group (peripheral group). All variables were compared between the two groups.Results: No significant differences were observed in age, sex, underlying diseases, history of ocular surgery, duration of ocular pain, tear film, ocular surface and Meibomian gland parameters (all p>0.05). Ocular pain and non-ocular pain severity and the percentage of time spent thinking about non-ocular pain were significantly higher in the central group than in the peripheral group (all p<0.05). Central group complained more commonly of a burning sensation than did the peripheral group (p=0.01).Conclusions: Patients with central-dominant sensitization may experience more intense ocular and non-ocular pain than the others and burning sensation may be a key symptom in those patients.

Determinants of Ocular Pain Severity in Patients With Dry Eye Disease

2017 ◽  
Vol 179 ◽  
pp. 198-204 ◽  
Author(s):  
Vannarut Satitpitakul ◽  
Ahmad Kheirkhah ◽  
Alja Crnej ◽  
Pedram Hamrah ◽  
Reza Dana
Keyword(s):  
Dry Eye ◽  
Dry Eye Disease ◽  
Pain Severity ◽  
Eye Disease ◽  
Ocular Pain

scholarly journals Ocular Surface Changes Associated with Ophthalmic Surgery

2021 ◽  
Vol 10 (8) ◽  
pp. 1642
Author(s):  
Lina Mikalauskiene ◽  
Andrzej Grzybowski ◽  
Reda Zemaitiene
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Anterior Segment ◽  
Dry Eye Disease ◽  
Postoperative Treatment ◽  
Eye Disease ◽  
Ophthalmic Surgery ◽  
Patient’S Satisfaction ◽  
The Impact ◽  
Anterior Segment Surgery

Dry eye disease causes ocular discomfort and visual disturbances. Older adults are at a higher risk of developing dry eye disease as well as needing for ophthalmic surgery. Anterior segment surgery may induce or worsen existing dry eye symptoms usually for a short-term period. Despite good visual outcomes, ocular surface dysfunction can significantly affect quality of life and, therefore, lower a patient’s satisfaction with ophthalmic surgery. Preoperative dry eye disease, factors during surgery and postoperative treatment may all contribute to ocular surface dysfunction and its severity. We reviewed relevant articles from 2010 through to 2021 using keywords “cataract surgery”, ”phacoemulsification”, ”refractive surgery”, ”trabeculectomy”, ”vitrectomy” in combination with ”ocular surface dysfunction”, “dry eye disease”, and analyzed studies on dry eye disease pathophysiology and the impact of anterior segment surgery on the ocular surface.

scholarly journals A systematic review assessing the quality of patient reported outcomes measures in dry eye diseases

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0253857
Author(s):  
Alberto Recchioni ◽  
Olalekan Lee Aiyegbusi ◽  
Samantha Cruz-Rivera ◽  
Saaeha Rauz ◽  
Anita Slade
Keyword(s):  
Psychometric Properties ◽  
Dry Eye ◽  
Full Text ◽  
Ocular Surface ◽  
Ocular Surface Disease ◽  
Reference List ◽  
Patient Reported ◽  
The Impact ◽  
Citation Searching

Background Patient-reported outcome measures (PROMs) can provide valuable insights on the impact of a disease or treatment on a patient’s health-related quality of life. In ophthalmology, particularly in dry eye disease (DED) and ocular surface disease (OSD), it is unclear whether the available PROMs were developed using comprehensive guidelines. To address this, we evaluated the methodological quality of studies assessing the psychometric properties of PROMs in DED and OSD [PROSPERO registration number CRD42019142328]. Methods Four databases were searched; reference list and citation searching of included studies was also conducted. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to appraise the quality of the studies evaluating the psychometric properties of PROMs used in DED and OSD. Results The search strategy (S3 Table) retrieved 5,761 records, 573 duplicates were removed, 5,188 abstracts were screened and 127 full-text articles were retrieved for further review. Of these, 118 full-text articles did not meet the eligibility criteria and were excluded. Reference list and citation searching, identified an additional 8 articles bringing the total numbers of papers reviewed to 17. In general, psychometric properties such as content validity, measurement error and structural validity were not assessed by the studies included in this review. Studies reviewing The Impact of Dry Eye on Everyday Life (IDEEL) presented with the highest quality scores together with the Ocular Surface Disease Index (OSDI) questionnaire. Conclusions The quality of studies evaluating PROMs in DED and OSD was considered using the COSMIN standards. The majority of the studies evaluating PROMs included in this review did not meet the recommended COSMIN criteria and the quality of the PROMs evaluated is not assured. Further evaluation of their psychometric properties is required if these are going to be used in clinical practice or research.

scholarly journals Clinical Characteristics of Dry Eye with Ocular Neuropathic Pain Features: Comparison According to the Types of Sensitization Based on the Ocular Pain Assessment Survey

2020 ◽  
Author(s):  
Jonghwa Kim ◽  
Hyeon Jeong Yoon ◽  
In Cheon You ◽  
Byung Yi Ko ◽  
Kyung Chul Yoon
Keyword(s):  
Neuropathic Pain ◽  
Dry Eye ◽  
Ocular Surface ◽  
Clinical Characteristics ◽  
Tear Film ◽  
Meibomian Gland ◽  
Burning Sensation ◽  
Ocular Pain ◽  
Central Group ◽  
Assessment Survey

Abstract Background: To compare the clinical characteristics of dry eye patients with ocular neuropathic pain features according to the types of sensitization based on the Ocular Pain Assessment Survey (OPAS).Methods: Cross-sectional study of 33 patients with dry eye and ocular neuropathic pain features. All patients had a comprehensive ophthalmic assessment including detailed history, the intensity and duration of ocular pain, the tear film, ocular surface, and Meibomian gland examination, and OPAS. Patients with <50% improvement in pain intensity after proparacaine challenge test were assigned to the central-dominant sensitization group (central group) and those with ≥50% improvement were assigned to the peripheral-dominant sensitization group (peripheral group). All variables were compared between the two groups.Results: No significant differences were observed in age, sex, underlying diseases, history of ocular surgery, duration of ocular pain, tear film, ocular surface and Meibomian gland parameters (all p>0.05). Ocular pain and non-ocular pain severity and the percentage of time spent thinking about non-ocular pain were significantly higher in the central group than in the peripheral group (all p<0.05). Central group complained more commonly of a burning sensation than did the peripheral group (p=0.01).Conclusions: Patients with central-dominant sensitization may experience more intense ocular and non-ocular pain than the others and burning sensation may be a key symptom in those patients.

scholarly journals Impact of Attrition, Intercellular Shear in Dry Eye Disease: When Cells are Challenged and Neurons are Triggered

2020 ◽  
Vol 21 (12) ◽  
pp. 4333 ◽  
Author(s):  
Gysbert-Botho van Setten
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Dry Eye Disease ◽  
Neural Regeneration ◽  
Eye Disease ◽  
Molecular Characteristics ◽  
Treatment Regimens ◽  
New Perspective ◽  
The Impact

The mechanical component in the pathophysiology of dry eye disease (DED) deserves attention as an important factor. The lubrication deficit induced impaired mechano-transduction of lid pressure to the ocular surfaces may lead to the dysregulation of homeostasis in the epithelium, with sensations of pain and secondary inflammation. Ocular pain is possibly the first sign of attrition and may occur in the absence of visible epithelial damage. Attrition is a process which involves the constant or repeated challenge of ocular surface tissues by mechanical shear forces; it is enhanced by the thinning of corneal epithelium in severe DED. As a highly dynamic process leading to pain and neurogenic inflammation, the identification of the impact of attrition and its potential pathogenic role could add a new perspective to the current more tear film-oriented models of ocular surface disease. Treatment of DED addressing lubrication deficiencies and inflammation should also consider the decrease of attrition in order to stimulate epithelial recovery and neural regeneration. The importance of hyaluronic acid, its molecular characteristics, the extracellular matrix and autoregulative mechanisms in this process is outlined. The identification of the attrition and recognition of its impact in dry eye pathophysiology could contribute to a better understanding of the disease and optimized treatment regimens.

scholarly journals Interactive effects of pain catastrophizing and mindfulness on pain intensity in women with fibromyalgia

2018 ◽  
Vol 5 (2) ◽  
pp. 205510291880740 ◽  
Author(s):  
Kathleen Dorado ◽  
Kristin L Schreiber ◽  
Alexandra Koulouris ◽  
Robert R Edwards ◽  
Vitaly Napadow ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Multilevel Modeling ◽  
Pain Catastrophizing ◽  
Pain Severity ◽  
Interactive Effects ◽  
Trait Mindfulness ◽  
Clinical Pain ◽  
Mindfulness Facets ◽  
Design And Testing

The objective of this study was to examine the association between facets of trait mindfulness, pain catastrophizing, and pain severity in a sample of patients with fibromyalgia. Patients with fibromyalgia completed validated baseline and diary assessments of clinical pain, mindfulness, and pain catastrophizing. Multilevel modeling analyses indicated that the daily association between catastrophizing and pain intensity was moderated by certain mindfulness facets. Our findings suggest that various aspects of mindfulness may interact differently with pain and catastrophizing, which may have implications for the design and testing of interventions targeting mindfulness and catastrophizing in fibromyalgia patients.

scholarly journals Unpredictable pain timings lead to greater pain when people are highly intolerant of uncertainty

2017 ◽  
Vol 17 (1) ◽  
pp. 367-372 ◽  
Author(s):  
Clémence Bélanger ◽  
Bernard Blais Morin ◽  
Andréanne Brousseau ◽  
Nicolas Gagné ◽  
Anne Tremblay ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Pain Perception ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Catastrophizing ◽  
Intolerance Of Uncertainty ◽  
Time Frame ◽  
Added Value ◽  
Subjective Pain ◽  
The Impact

AbstractBackground and purposeMany psychological factors are known to influence pain perception. Among them, intolerance of uncertainty (IU) may play a key modulating role in situations where uncertainty prevails, especially uncertainty regarding the timing of painful events. The objective of this study was to explore the impact of individual differences in IUon pain perception during predictable and unpredictable stimulation timings. We hypothesized that people with high IU, as opposed to those with low IU, would perceive more pain when the timing of painful stimulations cannot be predicted, as compared to when they can.MethodsTwenty (20) healthy adults, aged between 18 and 35 years old, were recruited. Painful sensations were provoked using transcutaneous electrical stimulations of the right sural nerve. By measuring IU (Intolerance of Uncertainty Scale) and subjective pain (verbal numerical rating scale), it was possible to test the relationship between IU and pain perception, by simulating predictable and unpredictable painful experiences. This was done through cued shock interval (CSI) blocks, with either variable timing or fixed timings (long or short time frame). Self-administered questionnaires were also used to measure pain hypervigilance, pain catastrophizing, state anxiety, and trait anxiety.ResultsPearson correlations confirmed the presence of an association (r = 0.63) between IU and the change in pain intensity provoked by unpredictable stimulation timings. Importantly, this association was significant only for stimulations provided at long CSIs, indicating that higher IU scores predicted higher pain intensity scores when stimulation timings became unpredictable, and when the cued delay was long. No association was found between pain scores and other psychological variables.ConclusionsOur results show that IU moderately correlates to the change in pain intensity provoked by unpredictable stimulation timings. High IU scores were associated with a worsening of the subjective pain experience, especially during long delays in an unpredictable situation. These observations suggest that IU could be considered as a psychological variable that is able to influence pain perception in certain situations.ImplicationsAssessing and addressing IU could be an added value in pain-related therapy, especially in chronic pain.

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