Dry Eye Syndrome as a Potential Sequel of Laryngopharyngeal Reflux: Shared Mechanisms and Clinical Implications

Laryngopharyngeal reflux (LPR) and dry eye syndrome (DES) are two prevalent conditions that significantly impair quality of life and present a growing challenge for otolaryngologists, gastroenterologists, and ophthalmologists alike. Although they affect different body regions, their common appearance in many patients has led to the reasonable assumption that they share common pathophysiological mechanisms. In this review, we aim to explore the epidemiological, pathophysiological and clinical correlations of LPR and DES. Evidence indicates that tear film synthesis and stability are often impaired in LPR patients. The abnormal presence of pepsin in the tears of LPR patients suggests reflux-mediated ocular surface damage. Moreover, the presence of overlapping comorbidities, autonomic dysfunction and common inflammatory cytokines makes their link even more evident. A combined treatment strategy involving alginates as an adjunct to ocular lubricants has recently shown promising results in the treatment of these patients. A multidisciplinary approach with the cooperation of many different medical specialties can improve symptoms and quality of life in patients who suffer from both conditions.