Can a Simple Eye Exam Chart the Course for Diagnosing and Managing Fibromyalgia?

Can a Simple Eye Exam Chart the Course for Diagnosing and Managing Fibromyalgia?

Can a routine, non-invasive and inexpensive eye exam help diagnose fibromyalgia (FM), and perhaps help guide the disease’s management? That’s a question researchers from Spain investigated, and found that it may well be true.

Using optical coherence tomography (OCT) – a non-invasive imaging test that uses light waves to take cross-section pictures of your retina – researchers detected that the retinal nerve fiber layer (RNFL) is atrophied in people with fibromyalgia, compared to controls.

They studied 116 people with fibromyalgia compared to 144 controls, and published their peer-reviewed study, “Fibromyalgia Is Correlated with Retinal Nerve Fiber Layer Thinning,” in this month’s issue of PLOS One

“The main finding in the present study evaluating RNFL parameters in patients with FM was the presence of axonal damage in the optic nerve of FM patients, even in early stages of the disease. Our results revealed that even patients with mild FM (Fibromyalgia Impact Questionnaire <60) exhibited subclinical RNFL atrophy in the temporal sectors,” wrote Elena Garcia-Martin, lead author of the study, and colleagues.

“The ability to evaluate the optic nerve as an indicator of the disease is an important advance,” they added.

The researchers also detected differences between fibromyalgia subgroups.  Specifically, those with biologic fibromyalgia, which is characterized by low depression and anxiety, but with high pain, had a significant decrease retinal nerve fiber layer in the temporal inferior and temporal superior areas compared to those who suffer from depressive or atypical fibromyalgia.

“Ophthalmologic tests are new, noninvasive, and cost-effective tools than can be used to facilitate the diagnosis of FM and may reduce the expenses associated with diagnosis of this disease,” they wrote.

Further evaluation of retinal nerve fiber layer in fibromyalgia sufferers is predicted to enhance the understanding of the disease etiology, and studies with larger sample sizes should detect greater differences between fibromyalgia subgroups.

“Longer-term studies are required to evaluate the clinical application of RNFL measurements in FM patients as 1) a diagnostic tool, 2) to follow disease progression, 3) to identify patients with worse prognosis or at higher risk for loss of quality of life, and 4) to measure treatment effectiveness,” they concluded.

Perhaps in the future, a trip to the ophthalmologist will be part of the diagnostic and disease management strategy for people with fibromyalgia.

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Authored by: Staff

There are 9 comments for this article
  1. John Quintner at 6:31 pm

    Danielle, who invented these sub-categories and what scientific evidence did they use to do so?

  2. Dannielle Berry at 4:35 pm

    I like the “subcategories” of fibromyalgia that they now somehow have. I wish the doctors would become educated in this. All doctors, not just Rheumatologists, because Rheumatologists are starting to kick patients that cannot take the “mainstream” drugs that are available to treat fibromyalgia, back to their Primary Care Physicians. Since I suffer from more pain and less depression, it’s good to know there’s “subcategories” to classify it. My eyesight is horrible. Keeps getting worse. The doctors keep insisting that I “probably” have something else, like an autoimmune disease, all the symptoms state that I do, yet all the testing keeps coming back negative.

  3. Ashley at 10:20 am

    A routine eye exam is how the ball got rolling on my diagnosis. I experienced what I came to call “growing pains” in my joints from the time I was a child. I thought the pain I was experiencing was due to a childhood of an active participation in sports and athletics. My eye dr. suggested that I see a rheumatologist, who 6 months later diagnosed me with fibromyalgia. I was diagnosed at 22 and am now 27. My symptoms are getting progressively worse and worse, however, keeping an optimistic outlook on life despite debilitating pain and keeping an active lifestyle has truly worked for me.

  4. John Quintner at 2:21 pm

    “Specifically, those with biologic fibromyalgia, which is characterized by low depression and anxiety, but with high pain, had a significant decrease retinal nerve fiber layer in the temporal inferior and temporal superior areas compared to those who suffer from depressive or atypical fibromyalgia.”

    Two comments:

    1. Who decided that there were subtypes of fibromyalgia (biological & depressive or atypical)? On what grounds was this determination made?

    2. Before drawing any more conclusions from this important study, a third control group would be necessary – consisting of those with persistent pain who do not fulfil the criteria for fibromyalgia.

  5. Jean Price at 11:32 pm

    I’d say this warrants more research and is an important finding if it plays out to be true! Having a firm diagnosis is the first step toward coping with invisible diseases! This would make it less medically invisible and that’s a start!

  6. JRL at 8:41 pm

    I too have problems with my eyes and have been checked and rechecked for MS by every neurologist I saw until a rheumatologist examined me and said with 100% certainty it is FM.

    It took four years to get my diagnosis and along the way I felt rejected by skeptical doctors who treated me as if I was overstating the severity of my symptoms.

    I am a 47 year old male, still stuck in bed on most days.

  7. MichaelL at 1:31 pm

    So now, they find something that might be a physical finding, in people with fibromyalgia. Those same people who did not have a disease at all, according to nurses and doctors who knew nothing about the syndrome, twenty years ago! I remember being called a “quack”. I guess that is a problem being a male physician diagnosed with it over twenty-five years ago! Everyone, that I diagnosed, thought I was a genius! I told them, “No! I am not”. I just had an open mind, and their disease! It will be great that so many people can, now, be treated like real patients instead of seen as “fakers” and “charlatans”!

  8. Reeda Hoefer at 9:52 am

    Interestingly, you dropped the most important part of the study, and I quote…

    “CONCLUSIONS: Fibromyalgia causes subclinical axonal damage in the RNFL that can be detected using innocuous and non-invasive OCT, even in the early disease stages. The impact on the RNFL in the temporal sectors is greater in patients with biologic fibromyalgia, suggesting the presence of NEURODEGENERATIVE PROCESSES in this subgroup of patients with fibromyalgia.”
    It’s past time that fibromyalgia receives proportional research funding!

  9. connie at 7:18 am

    Very interesting. Perhaps this is why my eye doctor keeps seeing changes within my eyes” consistent with MS ” yet doctors say I don’t have it. I do have severe fibromyalgia with definite loss of quality of life. I will be watching for more information on this study.