Tear osmolarity and subjective dry eye symptoms in migraine sufferers.

OBJECTIVE: Previous studies have suggested an association between dry eye and migraine. In a busy ophthalmologist clinic, quick identification of dry eye in migraine sufferers may improve their quality of life. Tear osmolarity is an objective and reliable tool for diagnosing dry eye. It has not been investigated in any population with migraine. Using tear osmolarity and questionnaires, we aimed to explore the relationship between dry eye and clinical symptoms in patients with migraine.

DESIGN: Prospective cross-sectional study.

PARTICIPANTS: Thirty-four adults with migraine sequentially recruited from a single neurologist's practice.

METHODS: Patients were assessed for subjective and objective signs of migraine and dry eye by using the Migraine Disability Assessment Score, the Ocular Surface Disease Index, and tear osmolarity (TearLab). Headache characteristics were compared by using χ2 , Fisher's exact, and Mann-Whitney U tests. Osmolarity scores were compared with scores for headache features.

RESULTS: Median age of patients was 38 years, and 76.5% were females. Severe migraine disability was reported in 75.6%, and 34.5% reported moderate to severe dry eye symptoms. Objectively, 49.5% had evidence of dry eye, significantly higher than the 20% recognized in the general population (p < 0.0001). Aura was found to occur more frequently with dry eye (43.8% vs 5.9%; p = 0.02). Those with daily headaches were also more likely to have higher tear osmolarity with marginal significance (median osmolarity 310 mOsm/L vs 299 mOsm/L; p = 0.08).

CONCLUSIONS: Patients with migraine, especially those with aura, appear more likely to have dry eye, as indicated by tear osmolarity. Tear osmolarity may also be greater in those who suffer from daily headaches.