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

• Published in: Clinical & experimental ophthalmology 2024-01, Vol.52 (1), p.10-21
• Main Authors: Sanchez, Victor, Kim, Colin K., Locatelli, Elyana V. T., Cohen, Adam K., Cabrera, Kimberly, Aenlle, Kristina, Klimas, Nancy G., O'Brien, Robert, Galor, Anat
• Format: Article
• Language: English
• Subjects: Canada; Chronic fatigue syndrome; chronic ocular pain; Cross-Sectional Studies; Diagnosis; dry eye; Dry Eye Syndromes - diagnosis; Dry Eye Syndromes - epidemiology; Encephalomyelitis; Eye diseases; Fatigue; Fatigue Syndrome, Chronic - diagnosis; Fatigue Syndrome, Chronic - epidemiology; Gulf War; Humans; Inflammation; Male; Middle Aged; Military personnel; myalgic encephalomyelitis; Neuralgia; neuropathic pain; Pain; Persian Gulf War; Prospective Studies; Questionnaires; United States - epidemiology; Veterans; War
• ISSN: 1442-6404; 1442-9071; 1442-9071
• DOI: 10.1111/ceo.14313

Background To examine ocular symptoms and signs of veterans with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) diagnosis, ME/CFS symptoms, and controls. Methods This was a prospective, cross‐sectional study of 124 South Florida veterans in active duty during the Gulf War era. Participants were recruited at an ophthalmology clinic at the Miami Veterans Affairs Hospital and evaluated for a diagnosis of ME/CFS, or symptoms of ME/CFS (intermediate fatigue, IF) using the Canadian Consensus criteria. Ocular symptoms were assessed via standardised questionnaires and signs via comprehensive slit lamp examination. Inflammatory blood markers were analysed and compared across groups. Results Mean age was 55.1 ± 4.7 years, 88.7% identified as male, 58.1% as White, and 39.5% as Hispanic. Ocular symptoms were more severe in the ME/CFS (n = 32) and IF (n = 48) groups compared to controls (n = 44) across dry eye (DE; Ocular Surface Disease Index [OSDI]: 48.9 ± 22.3 vs. 38.8 ± 23.3 vs. 19.1 ± 17.8, p