Confocal microscopy reveals nerve fiber similarities in fibromyalgia and patients with dry eyes with a normal ophthalmic exam

Small fiber neuropathy has been shown in a subset of fibromyalgia patients, but this is a non-specific finding that has been noted in several chronic pain states. Small nerve fiber morphology can be measured non-invasively in the cornea, an area densely innervated with small fibers, using in-vivo confocal microscopy (IVCM). We used this technique to determine if 1) neuropathy is present in the corneas of fibromyalgia patients and 2) if those who suffer from idiopathic, chronic dry eyes (i.e., dry eye symptoms without dry eyes on exam) might also have compromised small fibers.