Laryngopharyngeal Reflux and Eye: More Than a Hypothesis

Objective: Laryngopharyngeal reflux is a frequent medical condition affecting about 1/3 of the general population. Also, laryngopharyngeal reflux may involve the ocular surface. Dry eye disease is also a common disorder affecting any age. Dry eye disease is a multifactorial disease sustained by different causes. Methods: We reviewed the most recent evidence about the relationship between laryngopharyngeal reflux and eye. Results: There is documentation that pepsin may be detectable in the tears of laryngopharyngeal reflux patients. Notably, pepsin is produced only in the stomach, so it is a biomarker of gastric reflux. There is also the demonstration that patients with dry eye disease may have frequent laryngopharyngeal reflux comorbidity, and dry eye disease severity is associated with high odds of laryngopharyngeal reflux comorbidity. In addition, a preliminary trial suggested that treating also laryngopharyngeal reflux in dry eye disease patients with gastric reflux could be a promising strategy. As a result, it is conceivable to imagine that eye reflux could be a new nosologic entity. It seems reasonable to recommend that the management of laryngopharyngeal reflux patients should include the investigation of possible ocular comorbidity. Conclusions: Laryngopharyngeal reflux and dry eye disease are 2 common diseases that not rarely can be associated together. Thus, careful attention to these disorders should be paid to in clinical practice by otolaryngologists visiting patients with laryngopharyngeal reflux.