Ocular Microbiology and Immunology Group
Back to OMIG Main Page

< Previous | 2026 Agenda and Abstracts | Next >

2026 OMIG Abstract

POSTER PRESENTATION


Investigating Connections Between Autoimmune Dry Eye and Gastrointestinal Symptoms

Nikki Jagid¹, Robby Mattes^2,3, Luisa De Barros Saccaro^2,3, Loralei Parchejo³, Mireya Hernandez³, Christopher Alexopoulos¹, Divyang Bhatt¹, Miriam Marti³, and Anat Galor^2,3

¹University of Miami, Miller School of Medicine, Miami, Florida; ²Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, Florida; ³Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, Florida

Purpose: To examine associations between self-reported gastrointestinal (GI) symptoms and autoimmune-related dry eye disease (DED), compared to DED not associated with autoimmune conditions.

Methods: Cross-sectional study of 90 individuals with DED symptoms (Ocular Surface Disease Index [OSDI] > 13 or Dry Eye Questionnaire-5 > 6). Of this cohort, 58 patients had a diagnosed autoimmune disease and/or serological evidence of autoimmunity (a-DED), and the remaining 32 patients did not have evidence of autoimmunity (non a-DED). All participants completed validated GI questionnaires, including the Irritable Bowel Syndrome Severity Scoring System (IBS-SSS) and GI Symptom Rating Scale (GSRS). GI symptom analyses focused on the total IBS-SSS and GSRS scores, and individual GSRS items were grouped and averaged into five main symptom clusters: abdominal pain (AP), indigestion, reflux, diarrhea, and constipation. Associations between GI symptoms and DED symptoms and signs were evaluated.

Results: The mean age of the entire population was 63 + 13 years, with the a-DED group being younger (58 + 12 vs. 71 + 12 years) and having a higher proportion of females (69% vs. 16%). On IBS-SSS, the a-DED cohort had a higher burden of GI symptoms compared to the non a-DED group, with 59% reporting AP and/or distension (defined by bloating, swollen or tight stomach), compared with 25%. On GSRS, all GI symptoms were more frequent and severe in the a-DED versus non a-DED groups, including AP, distension, urgent need for defecation, and incomplete evacuation of stools (p < 0.001). In the a-DED group, Spearman correlations showed statistically significant associations between GI and DED symptoms, the strongest being between the AP symptom cluster and total OSDI score (ρ = 0.61, p < 0.001). In contrast, DED signs (tear-breakup time, Schirmer's, and corneal staining) were less strongly associated with GI symptoms (ρ < 0.29). Individuals with evidence of nerve dysfunction (periocular cutaneous allodynia [PCA]) scored higher on IBS-SSS (Mdn=260 [IQR 145-400] vs. 180 [62.5-261.3], p = 0.045) and GSRS questionnaires (19 [11.5-24.5] vs. 11 [6-17], p = 0.014), with notably more severe AP symptoms (AP cluster: 1.3 [0.3-1.8] vs. 0.7 [0-1], p = 0.007), compared to those without PCA. Forward linear regression modeling, adjusting for age, sex, race, and ethnicity, confirmed these relationships, with the AP symptom cluster remaining the most significant predictor of total OSDI (p < 0.001) and PCA, (p = 0.004), alongside IBS-SSS total, GSRS total, GSRS individual items, and GSRS symptom clusters.

Conclusions: Individuals with a-DED have a higher burden of GI symptoms than non a-DED, with high frequencies of clinically significant AP, distension, and IBS symptoms. Pain-related GI symptoms were more strongly associated with greater DED symptom severity and periocular cutaneous allodynia, but not with DED signs, suggesting a link to a DED subtype characterized by nerve dysfunction.