Tear Film and Dry Eye Characteristics as Predictors of Photophobia in 374 Patients with Dry Eye Disease.

PurposeMethodsResultsConclusion\nSUMMARYWhat was known beforeWhat this study addsTo assess the tear film parameters associated with photophobia in dry eye disease (DED).Three hundred seventy-four patients with DED (mean age, 42.2 ± 12.8 years) had their tear film and OSDI scores evaluated using Oculus keratograph 5 M (TMH, NIBUT, Meibography), Lipiview interferometer (LLT), and TearLab osmolarity system. Photophobia scoring from OSDI sheets was used to calculate the odds ratio via multivariate logistic regression analysis. Data from the eye with severely affected NIBUT was used.Of 374, 127 had aqueous deficient dry eye disease (ADDE), and 247 had evaporative DED. The mean age, female sex, Schirmer I, TMH, NIBUT, LLT, and tear osmolarity values in patients with photophobia versus no or mild photophobia were 42.2. vs. 40.9 years, 42% vs. 40%, 11.6 vs. 10.5 mm, 0.27 vs. 0.29 mm, 4.6 vs. 4.7s, 60.3 vs. 60.9 nm and 305 vs. 307 mOsm/L, respectively. Multivariate analysis revealed no tear film parameters predictive of photophobia in evaporative DED, whereas tear osmolarity had a weak negative association with photophobia (odds ratio of 0.96, 95% C.I, 0.92–1, <italic>p</italic> = .04) in ADDE patients.Tear film parameters do not predict the presence or absence of photophobia in DED except for a weak inverse association with tear osmolarity in ADDE. This suggests the role of central sensitization in regulating photophobia in DED patients.Photophobia is a common dry eye symptom. The severity of photophobia correlates with dry eye severity and improves with treatment.1. Tear film parameters, such as tear break-up time, tear volume, meibomian gland loss and lipid layer thickness do not predict photophobia risk in dry eye disease.2. This study provides the basis for future research in understanding the central neural sensitization in DED patients with photophobia. [ABSTRACT FROM AUTHOR]