HealthDay News — Pain sensitivity and pain tolerance are associated with symptoms of dry eye disease, according to a study published in JAMA Ophthalmology.

Jelle Vehof, PhD, from King’s College London, and colleagues conducted a cross-sectional study involving 1,622 female twin volunteers, aged 20 to 83 years, to explore whether pain sensitivity plays a role in patients’ experience of dry eye disease symptoms.

The Ocular Surface Disease Index (OSDI) questionnaire was completed by a subset of 689 women. Quantitative sensory testing was used to assess pain sensitivity and pain tolerance. A total of 27% of the participants had dry eye disease.

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Women with dry eye disease showed a significantly lower heat pain threshold (HPT) and heat pain suprathreshold (HPST), compared to those without the disorder, the researchers found. The presence of pain symptoms on the OSDI correlated significantly with the HPT and HPST.

Dry eye disease pain symptoms were almost twice as common for participants with an HPT below the median versus those with an HPT above the median.

“High pain sensitivity and low pain tolerance are associated with symptoms of dry eye disease, adding to previous associations with severity of tear insufficiency, cell damage and psychological factors,” the researchers wrote. “Management of dry eye disease symptoms is complex, and physicians need to consider the holistic picture, rather than simply treating ocular signs.”


  1. Vehof J et al. JAMA Ophthalmol. 2013; doi:10.1001/jamaophthalmol.