Ocular Microbiology and Immunology Group
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2026 OMIG Abstract

POSTER PRESENTATION


Quantitative Sensory Testing (QST) Identifies Somatosensory Abnormalities in Autoimmune Dry Eye Disease

Pranavi Garlapati, Pragnya R. Donthineni, Robby Mattes, Sakina Qazi, Nicholas J. Pondelis, Amanda Dynak, Deborah Jacobs, Joseph Ciolino, Eric A. Moulton, Elizabeth Felix, and Anat Galor

Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida

Purpose: To determine whether quantitative sensory testing (QST) identifies somatosensory abnormalities in individuals with autoimmune dry eye disease (DED).

Methods: Individuals with autoimmune DED (n=14) underwent ocular surface evaluation and QST using a 6-mm contact thermode. Cold pain ratings and prolonged aftersensations were assessed at the upper eyelid following standardized cold stimuli (20°C, 5°C, and 0°C). Heat pain thresholds (HPT), heat pain ratings (HPR), temporal summation (TS), and heat aftersensations (AS) were assessed at the forehead, forearm, and upper eyelid. Associations between QST measures and DED symptoms, ocular pain characteristics, and ocular surface findings were evaluated.

Results: The mean age of the population was 55.8+13.1 years; 75.8% identified as female and 69.7% as White. Cold pain ratings increased progressively with decreasing stimulus temperature, with the highest pain reported at 0°C (49.9+28.6). Overall, cold-evoked QST measures demonstrated stronger relationships with DED symptoms than heat-evoked measures, with OSDI showing the strongest associations (r=0.41-0.72), while DEQ5 demonstrated moderate associations primarily with prolonged cold aftersensations (r=0.54-0.56). Cold pain ratings and prolonged cold aftersensations were also strongly associated with neuropathic ocular pain features, particularly light-evoked pain and contact temperature-evoked pain (r=0.68-0.72). Associations with ocular surface signs were generally weaker, with the strongest observed between eyelid cold pain at 0°C and Schirmer test scores (r = -0.63). In contrast, heat pain thresholds, heat pain ratings, temporal summation, and heat aftersensations demonstrated generally weak or inconsistent relationships with symptoms and ocular surface findings.

Conclusions: Cold-evoked QST measures, particularly eyelid cold pain and prolonged cold aftersensations, demonstrated stronger associations with DED symptoms and neuropathic ocular pain than conventional ocular surface findings. These results suggest that QST may provide an objective approach for identifying altered somatosensory processing in autoimmune DED and may complement traditional ocular surface testing.