Assessment of keratoconjunctivitis sicca in patients with fibromyalgia: results of a prospective study

Patients with fibromyalgia (FM) often describe the presence of dry eyes and other ocular symptoms. It has been claimed that a subgroup of patients wit h FM might have features suggestive of primary Sjogren syndrome. In others, such a relationship could not be found. The purpose of the present study w as to investigate the association and prevalence of keratoconjunctivitis si cca (KCS) in patients with FM. Among 285 patients with FM, 40 patients repo rting sicca symptoms were screened with Schirmer's I test, break-up time an d Rose-Bengal score. KCS was diagnosed when two of the selected three tests gave pathological results. A detailed ophthalmological examination was als o performed. In 15 patients the diagnosis of KCS could be confirmed. Eighte en of 40 patients had been taking low-dose antidepressants and 7 of them ha d objective signs of KCS. Eight of 40 patients had signs of chronic blephar itis and 4 of them had KCS. Fourteen patients showed unremarkable test resu lts. Chronic blepharitis and the use of tricyclic antidepressants may play a role in developing KCS. It seems that the rate of KCS does not increase i n patients with FM and they probably have objective ocular findings compara ble with the normal population.