Researcher and clinicians have long wondered about the connection between dry eye disease (DED) and migraines. Early studies have suggested an association, but small sample sizes hampered their ability to quantify the link.1 A recent population-based study may finally reconcile this concern and provide concrete data on just how likely patients are to have concurrent conditions.2 Although the researchers admit that the study does not provide any insight into the cause and effect of the two conditions, they do note patients with migraines are more likely to have a concurrent diagnosis of DED than those who do not have migraines.

The study out of the University of North Carolina included 72,969 adult patients from a 10-year period between 2008 and 2018. They found 5,352 patients (7.3%) had a diagnosis of migraine headache and 9,638 (13.2%) had DED. The chance of having DED with migraine was 1.72x higher than it was for patients without migraine. Even after accounting for cofounding factors, the odds only dipped to 1.42.

“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,” the study concludes.

Other studies also suggest patients with DED may be more prone to migraines due to the ocular pain the condition causes.3 Not only could this discomfort help to trigger a migraine, but patients may also conflate ocular pain with migraine pain because they all travel along the same pain processing pathways.3

1. Koktekir BE, Celik G, Karalezli A, Kal A. Dry eyes and migraines: is there really a correlation? Cornea. 2012;31(12):1414-6.

2. Ismail OM, Poole ZB, Bierly SL, et al. Association between dry eye disease and migraine headaches in a large population-based study. March 7, 2019. [Epub ahead of print].

3. Digre K. More than meets the eye: the eye and migraine—what you need to know. J Neuro-ophthalmol. 2018;38(2):237-43.