Tear Film Instability in Patients with Irritable Bowel Syndrome: Evidence of a Gut–Eye Connection

Abstract

Background: The tear film is critical for maintaining ocular surface homeostasis, and its instability is a sign of dry eye illness. Recent research reveals that systemic diseases, especially gastrointestinal disorders like irritable bowel syndrome (IBS), may affect tear film performance via inflammatory and microbiome-mediated processes. Objective:  To assess tear film stability in IBS patients and look at any links between gastrointestinal dysfunction and ocular surface changes. Methodology: A cross-sectional study included 56 IBS patients (34 females and 22 males). Tear Film Break-Up Time (TBUT) was assessed using standard clinical procedures and classified as low (<5 s), moderate (5-10 s), or normal (>10 s). Gender differences and prevalence patterns were investigated using chi-square tests and odds ratios with 95% confidence. Result: Among IBS patients, 48.2% showed reduced TBUT (<10 s), indicating tear film instability. Low TBUT (<5 s) was reported in 12.5% of patients, while 35.7% showed significant instability. There were no significant gender differences (OR 0.89; 95% CI 0.30-2.60; p = 0.83). Conclusion:  Tear film instability was observed in over half of IBS patients, lending support to the gut-eye connection concept. These findings underline the importance of multidisciplinary examination of IBS patients, as ocular surface symptoms may be an underappreciated systemic manifestation. Larger controlled research are needed to understand the underlying processes and treatment implications.