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Original Investigation
March 7, 2019

Association Between Dry Eye Disease and Migraine Headaches in a Large Population-Based Study

Author Affiliations
  • 1Department of Ophthalmology, University of North Carolina, Chapel Hill
  • 2medical student, School of Medicine, University of North Carolina, Chapel Hill
  • 3Department of Biostatistics, Gillings School of Public Health, University of North Carolina, Chapel Hill
  • 4Department of Ophthalmology, University of Auckland, Auckland, New Zealand
JAMA Ophthalmol. 2019;137(5):532-536. doi:10.1001/jamaophthalmol.2019.0170
Key Points

Question  What is the association between dry eye disease and migraine headaches?

Findings  In this population-based case-control study of 72 969 patients, the odds of having dry eye disease with a diagnosis of migraine headaches was at least 20% higher than that of individuals without a diagnosis of migraine headaches.

Meaning  Although this association may not reflect cause and effect if unidentified confounders account for the findings, these results suggest that patients with migraine headaches may be at risk of carrying a comorbid diagnosis of dry eye disease.

Abstract

Importance  Reports in the literature have conflicting findings about an association between dry eye disease (DED) and migraine headaches.

Objective  To determine the strength of the association between DED and migraine headaches.

Design, Setting, and Participants  This retrospective case-control study included 72 969 patients older than 18 years from University of North Carolina–affiliated health care facilities from May 1, 2008, through May 31, 2018. Deidentified aggregate patient data were queried; data were analyzed from June 1 through June 30, 2018.

Exposures  Diagnosis of migraine headache.

Main Outcomes and Measures  Odds ratios calculated between DED and migraine headaches for participants as a whole and stratified by sex and age group.

Results  The base population consisted of 72 969 patients, including 41 764 men (57.2%) and 31 205 women (42.8%). Of these, 5352 patients (7.3%) carried a diagnosis of migraine headache, and 9638 (13.2%) carried a diagnosis of DED. The odds of having DED given a diagnosis of migraine headaches was 1.72 (95% CI, 1.60-1.85) times higher than that of patients without migraine headaches. After accounting for multiple confounding factors, the odds of having DED given a diagnosis of migraine headaches was 1.42 (95% CI, 1.20-1.68) times higher than that of patients without migraine headaches.

Conclusions and Relevance  These findings suggest that patients with migraine headaches are more likely to have comorbid DED compared with the general population. Although this association may not reflect cause and effect if unidentified confounders account for the results, these data suggest that patients with migraine headaches may be at risk of carrying a comorbid diagnosis of DED.

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