Fibromyalgia

Prof. Dr. Elisabeth M. Messmer

Augenklinik der Ludwig-Maximilians-Universität München

Mathildenstrasse

880336 München

The ocular surface encompasses a group of structures and tissues protecting the intraocular milieu from the continuous aggressions of the environment. The eyelids, tear film, surface epithelia, lacrimal glands, complex immunoregulation and trigeminal nerve sensation participate in these protective barriers. As they are relatively redundant and independently regulated, partial impairment of the defence barriers may be compensated by other protective systems and cause limited clinical consequences. When all barriers are impaired, however, or when the last defence is compromised, the ocular surface loses its ability to recover after any, even minor, environmental stress, and the ocular tissues enter a chronic pathological state in which the altered epithelia, immunoinflammatory cells and corneal nerves stimulate inflammation, which further degrades the tear film and causes additional tissue alteration, eventually acting as a self-stimulating vicious cycle.