Eye examinations could improve the management of patients with laryngopharyngeal reflux disease (LPR), according to a new study.

LPR symptoms typically consist of hoarseness, sore throat, the feeling of a lump in the throat and throat clearing. However, it is also suggested that reflux can impact the eyes.

Pepsin is a stomach enzyme produced during digestive activity; but has been previously identified in the saliva, ears and nasal cavity of people with reflux. Pepsin has now also been found in the tears of LPR patients and connected to problems, such as dry eye and blocked ducts.

A new study by researchers in Italy has evaluated alterations on the surface of the eye in patients with LPR. Furthermore, it uses the Peptest kit to also address the relationship between pepsin and the tear drainage system.

Tears are produced in the lacrimal gland under the skin above the eye and drain away through holes on the upper and lower eye lids. They then travel down the nasolacrimal duct into the nose.

The study – published in international science journal Life – found that patients with LPR showed ocular surface changes including epithelial damage and impairment of lacrimal function. Tear pepsin levels were detectable in 32 out of 50 patients with LPR.

Most of the LPR patients complained of eye discomfort symptoms, including itching (38 per cent), redness (56 per cent), or foreign body sensation (40 per cent). Tear pepsin levels were significantly correlated with the severity of LPR disease and with ocular surface changes.

In conclusion, the researchers suggest that a ‘multidisciplinary approach of LPR disease, including ophthalmological evaluation, should be performed in LPR patients in order to identify the presence of ocular surface changes and to improve the management of these patients’.

They also suggested the use of ‘PROD syndrome’ to describe eye surface changes in LPR patients – an acronym for ‘pepsin related ocular surface damage and dry eye’.

Download the ‘Evidence of Pepsin-Related Ocular Surface Damage and Dry Eye (PROD Syndrome) in Patients with Laryngopharyngeal Reflux’ study here.


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