{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:51:22Z","timestamp":1792065082882,"version":"4.4.0"},"reference-count":66,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004837","name":"Ministry of Science, Innovation and Universities (Government of Spain) and ERDF\/EU","doi-asserted-by":"publisher","award":["SAF-2016-77080-P MICIU\/ AEI\/10.13039\/501100011033"],"award-info":[{"award-number":["SAF-2016-77080-P MICIU\/ AEI\/10.13039\/501100011033"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministry of Science, Innovation and Universities (Government of Spain) and ERDF\/EU","doi-asserted-by":"publisher","award":["FPU17\/02715"],"award-info":[{"award-number":["FPU17\/02715"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministry of Science, Innovation and Universities (Government of Spain) and ERDF\/EU","doi-asserted-by":"publisher","award":["CLU-2023-1-04"],"award-info":[{"award-number":["CLU-2023-1-04"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Junta de Castilla y Le\u00f3n (Spain) and the European Regional Development Fund (FEDER)","award":["SAF-2016-77080-P MICIU\/ AEI\/10.13039\/501100011033"],"award-info":[{"award-number":["SAF-2016-77080-P MICIU\/ AEI\/10.13039\/501100011033"]}]},{"name":"Junta de Castilla y Le\u00f3n (Spain) and the European Regional Development Fund (FEDER)","award":["FPU17\/02715"],"award-info":[{"award-number":["FPU17\/02715"]}]},{"name":"Junta de Castilla y Le\u00f3n (Spain) and the European Regional Development Fund (FEDER)","award":["CLU-2023-1-04"],"award-info":[{"award-number":["CLU-2023-1-04"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The purpose of this study was to clinically characterize the lacrimal functional unit (LFU) of patients with chronic ocular pain associated with dry eye disease (DED). Methods: Ninety-three participants were included in this cross-sectional study: 28 patients with chronic ocular pain associated with DED (pain-DED), 35 patients with DED but no pain (no pain-DED), and 30 subjects without DED or ocular pain (controls). The following examinations were performed: symptom questionnaires, visual function assessment, tear meniscus, ocular surface evaluation, meibography, corneal sensitivity, Schirmer test, and in vivo corneal confocal microscopy. Results: Both DED groups presented increased DED-related symptoms (p &lt; 0.001), corneal staining (p &lt; 0.001), Meibomian gland loss (p &lt; 0.010), and dendritic cell density (p &lt; 0.001) compared with controls. Comparing both DED groups, the pain-DED group showed higher DED-related symptoms (p &lt; 0.002) and increased microneuroma density (p &lt; 0.001). Additionally, significant positive correlations were observed between symptom questionnaires and corneal staining (vs. OSDI: r = 0.514, p &lt; 0.001; vs. m-SIDEQ: r = 0.504, p &lt; 0.001; vs. NRS: r = 0.361, p &lt; 0.001; vs. WBFPRS: r = 0.317, p = 0.002), dendritic cell density (vs. OSDI: r = 0.429, p &lt; 0.001; vs. m-SIDEQ: r = 0.440, p &lt; 0.001), and microneuroma density (vs. NRS: r = 0.405, p &lt; 0.001; vs. WBFPRS: r = 0.416, p &lt; 0.001). Conclusions: Differences in the LFU, especially in the morphology of sub-basal corneal nerves, are related to the presence of DED and chronic ocular pain and, along with ocular clinical questionnaires, can help phenotype these patients.<\/jats:p>","DOI":"10.3390\/jcm14155250","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T14:11:44Z","timestamp":1753366304000},"page":"5250","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Clinical Characterization of the Lacrimal Functional Unit in Patients with Chronic Ocular Pain Associated with Dry Eye Disease"],"prefix":"10.3390","volume":"14","author":[{"given":"Marta","family":"Blanco-V\u00e1zquez","sequence":"first","affiliation":[{"name":"Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid (UVa), Campus Miguel Delibes, Paseo de Bel\u00e9n 17, 47011 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3072-3934","authenticated-orcid":false,"given":"Andrea","family":"Novo-Diez","sequence":"additional","affiliation":[{"name":"Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid (UVa), Campus Miguel Delibes, Paseo de Bel\u00e9n 17, 47011 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1926-0083","authenticated-orcid":false,"given":"Amanda","family":"V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid (UVa), Campus Miguel Delibes, Paseo de Bel\u00e9n 17, 47011 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1274-7796","authenticated-orcid":false,"given":"Amalia","family":"Enr\u00edquez-de-Salamanca","sequence":"additional","affiliation":[{"name":"Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid (UVa), Campus Miguel Delibes, Paseo de Bel\u00e9n 17, 47011 Valladolid, Spain"},{"name":"Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Campus Miguel Delibes, Paseo de Bel\u00e9n 17, 47011 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3673-0585","authenticated-orcid":false,"given":"Mar\u00eda J.","family":"Gonz\u00e1lez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid (UVa), Campus Miguel Delibes, Paseo de Bel\u00e9n 17, 47011 Valladolid, Spain"},{"name":"Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Campus Miguel Delibes, Paseo de Bel\u00e9n 17, 47011 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8178-4836","authenticated-orcid":false,"given":"Margarita","family":"Calonge","sequence":"additional","affiliation":[{"name":"Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid (UVa), Campus Miguel Delibes, Paseo de Bel\u00e9n 17, 47011 Valladolid, Spain"},{"name":"Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Campus Miguel Delibes, Paseo de Bel\u00e9n 17, 47011 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1097\/00003226-199811000-00002","article-title":"The Pathology of Dry Eye: The Interaction between the Ocular Surface and Lacrimal Glands","volume":"17","author":"Stern","year":"1998","journal-title":"Cornea"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.jtos.2017.05.008","article-title":"TFOS DEWS II Definition and Classification Report","volume":"15","author":"Craig","year":"2017","journal-title":"Ocul. 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