MIAMI — Veterans with Gulf War illness (GWI) have more severe dry eye (DE) symptoms, including neuropathic eye pain questionnaire scores, when compared to those who served during the Gulf War but did not meet criteria for GWI.
While dry eye complaints were mostly similar between the groups, however, specific GWI symptoms, including neurologic and gastrointestinal, correlated with more severe DE symptoms, according to a report in the American Journal of Ophthalmology.
Using a prospective cross-sectional study, researchers from the Miami VAMC, the University of Miami Miller School of Medicine and the New York University Grossman School of Medicine assessed DE symptoms and signs in individuals with versus without WI).
Included were South Florida veterans who were on active duty during the Gulf War era (GWE; 1990-91) and examined at an eye clinic between Oct. 1, 2020, and March 13, 2021.
Researchers divided veterans into two groups: 30 who met Kansas criteria for GWI and 41 who did not. The study team assessed DE symptoms using standardized questionnaires, while DE signs were assessed using a series of ocular surface parameters.
Results indicate that veterans with GWI had higher DE symptoms scores compared to controls (Ocular Surface Disease Index (OSDI) scores: mean 41.20±22.92 vs 27.99±24.03, p=0.01). Veterans with GWI also had higher eye pain scores compared to controls (average eye pain over past week: 2.63±2.72 vs 1.22±1.50, p=0.03), including on neuropathic ocular pain questionnaires (Neuropathic Pain Symptom Inventory- modified for the Eye (NPSI-E): 17.33±17.20 vs 9.63±12.64, p=0.03), the researchers reported.
They added, however, that DE signs were mostly similar between the groups, although GWI symptoms “nausea or upset stomach” (β=14.58. SE=3.02, p<0.001) and “headache” (β=7.90, SE=2.91, p=0.011) correlated with higher OSDI scores.
“Individuals with GWI have more severe DE symptoms and ocular pain scores but similar tear and ocular surface parameters compared to controls without GWI,” the researchers concluded. “This finding suggests that mechanisms beyond tear dysfunction drive eye symptoms in GWI.”
- Sanchez V, Baksh BS, Cabrera K, Choudhury A, Jensen K, Klimas N, Galor A. Dry eye symptoms and signs in US veterans with Gulf War Illness. Am J Ophthalmol. 2021 Nov 12:S0002-9394(21)00588-2. doi: 10.1016/j.ajo.2021.11.010. Epub ahead of print. PMID: 34780800.