Genetic Study Links Dry Eye Disease to Chronic Pain Conditions

By Office of the President | Nov 3, 2026

photo illustration of side-view of a womans upper face showing the left eye with a background of a dna strand

Why do some people with dry eye disease experience persistent pain, even when conventional treatments provide limited relief?

A national genetics study involving three Downstate researchers offers an important clue: dry eye disease and several chronic pain conditions share genetic influences that may help explain differences in symptoms and treatment responses.

Published September 25 in eBioMedicine, the study included Tim B. Bigdeli, Ph.D., Co-Director of Downstate’s Institute for Genomics in Health, and faculty members Peter B. Barr, Ph.D., and Chris Chatzinakos, Ph.D. All three also conduct research through the VA New York Harbor Healthcare System in Brooklyn.

Using data from the VA’s Million Veterans Program, researchers compared genetic information from more than 132,000 veterans with dry eye disease and 352,000 without it, making this one of the largest genetic studies of clinically recognized dry eye disease.

The team identified 10 genetic associations across nine regions of the genome, including newly identified variants associated with dry eye disease. The analysis also revealed genetic overlap with fibromyalgia, post-traumatic stress disorder, and Sjögren’s disease, with findings pointing toward biological processes involving nerve signaling and immune function.

One particularly significant finding involved a genetic factor shared with chronic pain conditions, which accounted for 51 percent of the genetic variance in dry eye in the researchers’ model. This does not mean chronic pain causes 51 percent of dry eye cases. Rather, it suggests that some of the biological processes influencing pain elsewhere in the body may also contribute to eye discomfort.

For patients, the findings offer a possible explanation for why dry eye symptoms vary considerably and why treatments directed primarily at the eye’s surface may not fully address persistent pain.

The results do not yet change clinical practice; however, they provide a foundation for research that could eventually support more individualized treatment approaches.

Dr. Bigdeli and Anat Galor, M.D., MSPH, Professor of Ophthalmology at the University of Miami and a physician at the Miami VA, are also leading new VA-funded research examining how dry eye develops and progresses. Their work seeks to identify differences among patients and better understand the biological processes underlying various forms of pain.

The research demonstrates the value of Downstate’s collaboration with the VA and the potential for discoveries involving veteran populations to inform care for patients more broadly.