Dry Eyes More Common In Certain Chronic Pains and Made Worse by Low Vitamin D – Replacement Helps

Prior I wrote about a Dry Eye- Mouth Syndrome (DEMS) that has some joint involvement. DEMS is associated with thyoid antibodies suggesting an autoimmune process (1).

Now It was found more commonly in irritable bowel, chronic pelvic pain and irritable bowel. But most interestingly, low Vitamin D worsens the symptoms and supplementation helps

Vehof  2016  (2) found dry eye symptoms could include:

  • light sensitivity
  • gritty feeling
  • painful eyes
  • blurred vision
  • poor vision
  • reading problems
  • problems driving at night
  • problems working on computer
  • problems watching TV
  • uncomfortable in windy weather
  • uncomfortable in low humidity
  • discomfort in air conditioned area

They found higher rates of Fibromyalgia (FM), irritable bowel, and pelvic pain.

An article looking at FM specifically(3), found 1.39 times  (males) – 1.45 times the risk (females) of dry eyes in FM. “FM patients aged ≤49 years had an elevated 80% risk of DES [dry eye syndrome] – compared with the non-FM group.”

Most interesting was the finding of low vitamin D with dry eyes(4). Even more exciting, was the finding Vitamin D supplementation in those low, might improve dry eyes(5)

  • 105 cases refractory to conventional treatment and known to have low vitamin D
  • Were given “Intramuscular injection of cholecalciferol (200,000 IU)”

Results:

This paralleled reduction in symptoms.

Comment – studies with low Vitamin D and back pain used Vitamin D2= Osto-D2 50,000 units orally every 5-7 days with relief of pain so I would use same doses here.  However, could try 4000 units daily if no doctor to prescribe other. It has recently been postulated that dry eyes might have a neuropathic connection(6). I have used Cyclosporin drops  in serious cases but it is expensive(7).

1) Muscle-Joint Pains, Dry Mouth and Eyes? – Maybe You Have DEMS/SAPS with Thyroid Antibiodies
http://painmuse.org/?p=188

2)Vehof, Jelle, et al.Clinical characteristics of dry eye patients with chronic pain syndromes.American journal of ophthalmology 162 (2016): 59-65.
http://www.ajo.com/article/S0002-9394(15)00705-9/abstract

3) Chen, Chao-Hsien, et al. “Dry eye syndrome risks in patients with fibromyalgia: A national retrospective cohort study.” Medicine 95.4 (2016): e2607.
http://journals.lww.com/md-journal/subjects/Rheumatology/Fulltext/2016/01250/Dry_Eye_Syndrome_Risks_in_Patients_With.39.aspx

4) Shetty, Rohit, et al. “Lower Vitamin D Level and Distinct Tear Cytokine Profile Were Observed in Patients with Mild Dry Eye Signs but Exaggerated Symptoms.” Translational Vision Science & Technology 5.6 (2016): 16-16.
http://tvst.arvojournals.org/article.aspx?articleid=2593403

5)Bae, Seok Hyun, et al. “Vitamin D Supplementation for Patients with Dry Eye Syndrome Refractory to Conventional Treatment.” Scientific Reports 6 (2016).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5048427/pdf/srep33083.pdf

6) Kalangara, Jerry P., et al. “Burning Eye Syndrome: Do Neuropathic Pain Mechanisms Underlie Chronic Dry Eye?.” Pain Medicine 17.4 (2016): 746-755.
http://painmedicine.oxfordjournals.org/content/17/4/746.abstract

7) Kymionis GD, Bouzoukis DI, Diakonis VF, Siganos C. Treatment of chronic dry eye: focus on cyclosporine. Clinical Ophthalmology (Auckland, NZ). 2008;2(4):829-836.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699789/pdf/co-2-829.pdf

 

 

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