Nerve dysfunction—not problems with the ocular surface—may be the root cause of dry eye symptoms in some patients with migraines, a study in the British Journal of Ophthalmology suggests.

Since many patients who suffer from migraines also report dry eye symptoms, researchers sought to find out whether their dry eye profiles were similar to those who were headache free.

Investigators evaluated symptoms and signs of dry eye—including those suggestive of nerve dysfunction—in a large group of individuals with dry eye symptoms who were seen at the Miami Veterans Administration Medical Center.

The prospective cross-sectional study enrolled 250 individuals, including 31 who met International Classification of Headache Disorders criteria for migraine based on a validated screening.

The study found individuals with migraines were significantly younger and more likely to be female than those in the control group (57 years vs. 62 years; 26% vs. 6%, respectively). Additionally, patients with migraine had more severe dry eye symptoms and ocular pain compared with those in the control group. Investigators also found a difference in symptom profiles between the groups, despite observing similar ocular surface parameters.

Individuals with migraine had a different dry eye symptom profile—yet a similar dry eye sign profile—compared with controls without migraine, researchers said. This suggests dry eye symptoms in individuals with migraine may be driven by nerve dysfunction as opposed to ocular surface abnormalities, they added.

Farhangi M, Diel R, Buse DC, et al. Individuals with migraine have a different dry eye symptom profile than individuals without migraine. Br J Ophthalmol. April 30, 3019. [Epub ahead of print].