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Are people with migraines destined to suffer from dry eye disease?

A large U.S. study investigates whether patients who have migraine headaches are more likely to be afflicted with dry eye disease.

Dry eye disease is a diagnosed eye disorder that affects the tears, which moisturize and lubricate the eyes. When a patient has this disease, their tears have poor quality and break up faster. Poor tear quality can cause symptoms of burning, irritation, and blurry vision. When advanced, dry eye disease can permanently damage the eyes and worsen the quality of life. A large percentage of the population in the U.S. suffers from this disease.

Dry eye disease and migraines lower the quality of life

Migraine headaches are also very common and can lessen a person’s quality of life. According to the Migraine Research Foundation, it is the third most common illness in the world. Migraine headaches are more severe than a bad headache; they are a neurological disease. Their symptoms may include severely throbbing head pain, nausea, vomiting, tingling, visual changes, dizziness, and extreme sensitivity to light and sound. They are more common in women and can last anywhere from a few hours to 72 hours.

Past studies have revealed a possible connection between dry eye disease and migraine headaches. However, these studies had conflicting results and multiple limitations, including a few participants. Researchers at the University of North Carolina (UNC) designed a larger study that aimed to discover if people diagnosed with migraine headaches are also more likely to be diagnosed with dry eye disease.

The study, published in JAMA Ophthalmology, included data from a group of over 72,000 patients in the UNC ophthalmology clinic over a 10-year period. The group included about 60% men and 40% women. Through an online system, researchers identified patients within this group with a diagnosis of migraine headache or dry eye disease. They further divided the group into subgroups that included age and sex. Using computer software, the researchers performed statistical tests on the data. They repeated the analysis after taking into account factors that can cause dry eye disease: certain medications, history of an autoimmune disease, and eye surgery.

Patients with migraines have a greater risk of dry eye disease

The study found that patients diagnosed with migraine headache have a 20% greater risk of being diagnosed with dry eye disease. Men and women between 55 to 64 years of age show an even greater link between both diseases. Overall, being female and older age appear to play a major role in the strength of the link between migraine headaches and this disease. The researchers proposed that the two diseases may be linked due to a shared inflammatory process, although this was not conclusive.

The study contained a few limitations. First, it only included patient data from one clinic, which generalizes the results. Second, unknown factors involved in this disease may have affected the results. Lastly, the study was unable to determine if the link between migraine headache and dry eye disease is unrelated and by chance. However, the study included exceedingly large numbers of patient data. This greatly strengthened the results of the statistical tests, making the researchers confident in the results of their analysis.

Researchers concluded that patients with migraine headache are more likely to be diagnosed with dry eye disease. They suggested that physicians who treat patients with migraine headache should consider that their patient may be at risk for dry eye disease.

Written by Mindy Nash, OD


  1. Ismail OM, Poole ZB, Bierly SL, et al. Association Between Dry Eye Disease and Migraine Headaches in a Large Population-Based Study. JAMA Ophthalmol. March 2019. doi:10.1001/jamaophthalmol.2019.0170
  2. Is dry eye disease associated with migraine headaches? [news release]. University of North Carolina; March 7, 2019. EurekAlert! Web site. 2019-03/jn-ide030519.php. Accessed March 20, 2019.
  3. Migraine Facts. Migraine Research Foundation. about-migraine/migraine-facts/. Accessed March 20, 2019.


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