Dry eyes and migraines: is there really a correlation?

Purpose: The purpose of this study was to evaluate the tear film functions and clinical symptoms of patients with migraines.

Methods: This observational comparative study consisted of 33 migraine (26 women and 7 men) patients referred from neurology clinics and 33 (22 women and 11 men) control subjects referred from ophthalmology outpatient clinics. The control subjects had neither systemic nor ocular disease nor any type of headache. All 66 patients underwent a complete ophthalmic examination and diagnostic tests for dry eye, including tear break-up time, Schirmer test with topical anesthesia, lissamine green staining, and an ocular surface disease score. Patients with migraine were classified as migraine with an aura, migraine without an aura, and basilar migraine; a pain score from 1 to 4 was determined for each patient, based on the American Headache Society's Migraine Disability Assessment Test.

Results: Of the 33 patients who participated in the migraine group, 17 (51%) suffered from migraine with aura, 11 (33%) suffered from migraine without aura, and 5 (15%) suffered from basilar migraine. Significant differences in dry eye scores were found between the patients with migraine and the control subjects. In the migraine group, the mean tear break-up time was 7.75±2.37 seconds, whereas in the control group it was 9.15±1.93 seconds. For the Schirmer test, the migraine group had a mean value of 12.09±4.95 mm/5 minutes, whereas the control group had a mean value of 14.90±4.26 mm/5 minutes. Testing with lissamine green staining resulted in a mean value of 1.00±0.16 in the migraine group and 0.30±0.46 in the control group. In the migraine group, the mean for the ocular surface disease index scoring was 36.27±17.54. In the control group, it was 28.42±9.0. A significant difference (P<0.05) was found in the dry eye syndrome testing results between the 2 groups in this study.

Conclusions: An increased frequency of dry eye disease was found to occur in patients with migraine, which might suggest that migraine headaches are related to dry eye disease. Some migraine attacks may be aggravated in the presence of dry eye syndrome.