Dry Eye Symptoms and Signs in US Veterans With Gulf War Illness

Dry eye symptoms and signs in United States Gulf War era veterans with myalgic encephalomyelitis/chronic fatigue syndrome

“…An ocular phenotype of symptoms out of proportion to signs has also been noted in individuals with GWI symptoms 48 . In our prior study, OSDI scores were higher in 30 individuals with GWI compared to 41 controls (41.2 ± 22.9 vs. 28.0 ± 8.2, p < 0.01), while ocular surface signs such TBUT and Schirmer scores were similar between groups 49 .…”

“…48 In our prior study, OSDI scores were higher in 30 individuals with GWI compared to 41 controls (41.2 ± 22.9 vs. 28.0 ± 8.2, p < 0.01), while ocular surface signs such TBUT and Schirmer scores were similar between groups. 49 In our current study, ME/CFS more closely associated with ocular symptoms severity than GWI symptoms on multivariable analysis, which may point to fatigue as a common denominator to the ocular pain experienced in both diseases. The shared findings between various pain conditions and an ocular phenotype of discordance between symptoms and signs suggests that similar mechanisms may underlie ocular pain across these conditions.…”

“…An ocular phenotype of symptoms out of proportion to signs has also been noted in individuals with GWI symptoms 48 . In our prior study, OSDI scores were higher in 30 individuals with GWI compared to 41 controls (41.2 ± 22.9 vs. 28.0 ± 8.2, p < 0.01), while ocular surface signs such TBUT and Schirmer scores were similar between groups 49 . In our current study, ME/CFS more closely associated with ocular symptoms severity than GWI symptoms on multivariable analysis, which may point to fatigue as a common denominator to the ocular pain experienced in both diseases.…”

“…Cases were diagnosed based on the CCC criteria for ME/CFS which requires evidence of sub substantial reduction in function defined by low scores in 2 of 3 SF-36 domains: physical (<50), social functioning (<62.5), or vitality (<35). 29 In addition, based on the DePaul questionnaire, cases had to have ≥6 months of fatigue (question 69) which was not lifelong or the result of exertion (questions 67, 69, 77, and 89), post-exertional malaise (at least one symptom from questions 14-18), sleep problems (at least one symptom from questions [19][20][21][22][23][24], pain in any of multiple compartments (at least one symptom in questions [19][20][21][22][23][24], neurological/cognitive problems including but not limited to problems with memory, concentration, and word finding (at least two symptoms from questions 32-44) and at least one symptom from two of the following areas: autonomic (questions [45][46][47][48][49][50][51], neuroendocrine (questions 52-61), and immune (questions 62-66). 29 Individuals who met either the SF-36 criteria, or the DePaul criteria, but not both were grouped into an intermediate fatigue (IF) group.…”

Pyridostigmine Bromide Pills and Pesticides Exposure as Risk Factors for Eye Disease in Gulf War Veterans

“…Though ocular symptoms are not included as a diagnostic criterion in GWI, our previous studies have found that dry eye (DE) symptoms, including discomfort, dryness, and foreign body sensation, were more severe in deployed GW veterans with GWI symptoms versus controls (deployed without symptoms or non-deployed). Specifically, Ocular Surface Disease Index (OSDI) scores were significantly higher in veterans with GWI symptoms (n = 30) versus controls (n = 41) (41.20 ± 22.92 vs. 27.99 ± 24.03, p = 0.01) [ 13 ]. In addition to DE symptoms, retinal nerve fiber layer (RNFL) thinning has been noted in deployed GW veterans with GWI symptoms (n = 28) versus controls (n = 38), with the largest difference seen in the inferior RNFL (109.33 ± 26.20 μm vs. 117.00 ± 24.29 μm, p = 0.13) [ 14 ].…”