Fibromyalgia and Dry Eyes and Mouth

By Dr Ananya Mandal, MD

Fibromyalgia is typically characterized by widespread pain, fatigue, headaches, irritable bowel syndrome, inability to get refreshing sleep, waking up tired and stiff and developing cognitive disturbances including lack of concentration and clumsiness, dizziness etc.

Fibromyalgia syndrome is a chronic and long term condition that has no cure. About 10 million people are currently diagnosed with this disorder. Although 9 out of 10 people diagnosed are women, men also get this disorder.

Fibromyalgia association with other conditions

Studies have shown that fibromyalgia is also associated with several other conditions. Typically some patients with fibromyalgia also experience dryness of the cornea or eyes and mouth.

Presence of ocular discomfort or eye dryness and grittiness is one of the more common complaints of fibromyalgia compared to oral or mouth dryness. Studies have shown that there may be alteration in formation of tears when compared to general population.

Sjogren’s syndrome

A syndrome condition called Sjogren’s syndrome is typically characterized by dry eyes and inability to form tears. It has been seen, however, that fibromyalgia patients with dry eyes and dry mouth do not satisfy criteria for diagnosis of Sjogren’s syndrome. They are commonly diagnosed with Dry eye and mouth syndrome (DEMS).

Corneal sensitivity and corneal changes

A study looking at corneal sensitivity and corneal changes among fibromyalgia patients shows that the sensitivity is same irrespective of age of the fibromyalgia patients. This could be due to the deterioration of the nerves and sensory systems of the eye.

Association between fibromyalgia, chronic fatigue and Sjogren’s syndrome

The study also finds association between fibromyalgia, chronic fatigue and Sjogren’s syndrome.

Tear secretion is markedly decreased in fibromyalgia but not to the extent of other dry eye conditions. Further the eye becomes more sensitive to high levels of carbon dioxide, heat, and cold compared to normal persons.

Normal tear formation

Normal tear formation is controlled by the lacrimal functional unit that includes cornea, conjunctiva, accessory lacrimal glands, and meibomian glands. These are all connected with a fine network of nerves.

If any portion of this nerve network is impaired, tear production may be hampered. This is something that occurs in fibromyalgia patients.

Dry mouth

Fibromyalgia is closely associated with irritable bowel syndrome and reduced salivary secretions leading to dry mouth. Dry mouth in itself is rarely present. It is more commonly associated with dry eyes in patients with fibromyalgia.

Reviewed by April Cashin-Garbutt, BA Hons (Cantab)

Sources

  1. http://ibs-care.org/pdfs/ref_078.pdf
  2. http://rheumatology.oxfordjournals.org/content/41/4/416.full.pdf
  3. http://www.iovs.org/content/50/9/4129.full.pdf

Further Reading

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