People With Fibromyalgia Have Higher Rates of Astigmatism, Dry Eye, MGD

New research has revealed that patients with fibromyalgia syndrome (FMS) had higher rates of astigmatism, meibomian gland dysfunction (MGD), and dry eye disease (DED) than those without, emphasizing the importance of routine anterior segment assessments in this population.1

“In recent years, there has been a growing interest in the ophthalmologic involvement of FMS as research has begun to reveal ocular manifestations in these patients. Among the most common complaints are dry eye symptoms, photophobia, and vision problems, all of which are hypothesized to be associated with immunological alterations and autonomic nervous system dysfunctions… Patients with chronic pain syndrome have dry eye symptoms, even when their clinical grade of ocular surface illness is comparable to or less severe than that of dry eye patients without chronic pain. Ocular manifestations may contribute to the overall burden of the disease; nevertheless, the comprehensive level of ocular involvement in FMS is still not completely understood,” lead investigator Duygu Topaktaş Emekli, Department of Ophthalmology, Adana City Training and Research Hospital, Adana, Turkey, and colleagues wrote.1

In this cross-sectional and comparative analysis, Emekli and colleagues collected data at a tertiary care education and research hospital from August 2024 to November 2024. They evaluated participants’ central corneal thickness, uncorrected and best-corrected visual acuities, refraction parameters, intraocular pressure, MGD, and DED.

The investigators did not find any significant differences in visual acuity, spherical equivalent, intraocular pressure, or central corneal thickness between FMS and healthy controls (all P >.05). They did find differences in astigmatism, MGD, and DED. Specifically, the FMS group had median astigmatism of − 0.50 (range, -8.25–0) in the right eye (diopter) compared with − 0.12 (range, -1.75–0.50) in the control group (P = .012); and − 0.50 (range, -2–1.50) in the left eye compared with and 0 (range, -1.75–0.75) in the control group.1

Furthermore, 36.6% (n = 26) of the FMS group had MGD and 60.6% (n = 43) had DED, compared with 4.3% (n = 3; P <.001) and 21.4% (n = 15; P <.001) in the control group, respectively.1

“These data show that FMS may predispose to these issues. The increased frequency of dry eye disease and meibomian gland dysfunction in FMS patients underscores the necessity for regular ocular assessments in this patient group. Future research should prioritize longitudinal studies with larger sample sizes to ascertain causal links and investigate the temporal dynamics of ocular alterations in FMS. Furthermore, assessments of drug effects, autonomic function, and psychiatric abnormalities (such as depression, anxiety, and sleep issues) are crucial for clarifying the underlying mechanisms and pinpointing prospective treatment strategies,” Emekli and colleagues concluded.1

Emekli and colleagues previously conducted a similar study evaluating ophthalmic vascular and neuroretinal alterations in people with FMS and found only slight differences in retinal parafoveal thickness and foveal density in FMS patients, with no substantial vascular or neurodegenerative alterations compared to healthy controls.2

REFERENCES

1. Emekli DT, Sahutoglu E, Öztürk GY, Kocyigit BF. Anterior segment alterations in fibromyalgia syndrome: a cross-sectional study on dry eye disease, meibomian gland dysfunction, and astigmatism. Rheumatol Int. 2025;45(5):120. Published 2025 Apr 25. doi:10.1007/s00296-025-05872-w

2. Öztürk GY, Emekli DT, Sahutoglu E, Kocyigit BF. Evaluation of ophthalmic vascular and neuroretinal alterations in fibromyalgia syndrome: a cross-sectional comparative study. Rheumatol Int. 2024;44(9):1757-1765. doi:10.1007/s00296-024-05662-w