Tear function alterations in patients with polycystic ovary syndrome

Complaints of dry eye are prevalent worldwide and are known to be associated with insulin resistance (IR) and hyperandrogenism. However, dry eye is often overlooked in the context of polycystic ovary syndrome (PCOS). The aim of the present study was to evaluate whether or not there is any relation between tear functions and PCOS, which is a multifaceted disorder associated with IR or hyperandrogenism.

A total of 35 women with polycystic ovary syndrome (PCOS) were enrolled in this study, along with 27 healthy controls. Body mass index (BMI), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and free testosterone levels on the third day of menstruation were recorded, as well as hirsutism score (using the Ferriman Gallwey scoring system), insulin resistance (homeostasis model assessment), neutrophil-to- lymphocyte ratios (NLR), platelet-to-lymphocyte ratios (PLR), and mean platelet volumes (MPV). A complete ocular examination was followed by administration of the ocular surface disease index (OSDI) questionnaire and Schirmer and tear break-up time (TBUT) tests.

Schirmer and OSDI results were similar between groups, but TBUT was significantly lower in the PCOS group (p = 0.002). There were negative correlations between FG score and TBUT test (r = -0.406, p = 0.001) and between NLR and Schirmer test (r = -0.294, p = 0.025).

Although subjective dry eye symptoms do not present in all patients, these results confirm that tear reduction, which can cause further complications in patients with PCOS, can be detected by careful examination and sensitive tests.