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Corneal Sensitivity Testing Procedure for Ophthalmologic and Optometric Patients
Published on: August 2, 2024
Corneal pain without stain: is it real?
Perry Rosenthal1, Inna Baran, Deborah S Jacobs
1Boston Foundation for Sight, Needham, MA 02494, USA. prosenthal@bostonsight.org
The Ocular Surface
|February 14, 2009
Summary
Neuropathic corneal pain causes discomfort without clear signs, challenging diagnosis and treatment. Recognizing it as a distinct condition is key to better therapies for affected patients.
Area of Science:
- Ophthalmology
- Neuroscience
- Pain Medicine
Background:
- Clinicians face challenges with patients reporting corneal pain but lacking objective signs, often associated with dry eye disease.
- These patients present a diagnostic and therapeutic dilemma, potentially leading to underdiagnosis or dismissal.
- Understanding the underlying mechanisms is crucial for effective patient management.
Purpose of the Study:
- To review the physiology of pain and the pathophysiology of neuropathic corneal pain.
- To explore potential etiopathogenic triggers, including LASIK, severe dry eye disease, and Sjogren syndrome.
- To advocate for the recognition of neuropathic corneal pain as a distinct disease entity.
Main Methods:
- Literature review focusing on pain physiology and corneal neuropathic pain mechanisms.
- Analysis of potential triggers and their role in disease development.
- Synthesis of current understanding to propose a framework for recognizing and treating the condition.
Main Results:
- Corneal neuropathic pain can occur independently of overt clinical signs.
- Identified potential triggers include refractive surgery (LASIK), severe dry eye, and autoimmune conditions like Sjogren syndrome.
- Current diagnostic and therapeutic approaches are often inadequate for these patients.
Conclusions:
- Recognizing neuropathic corneal pain as a distinct disease is essential.
- This recognition is the first step toward developing targeted and effective treatments.
- Improved understanding and management are needed for severely affected patients.
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