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    Ocular pain, often without clear neurological signs, presents diagnostic challenges. Conditions range from primary headaches and dry eye disease to serious issues like giant cell arteritis and orbital masses.

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    Area of Science:

    • Ophthalmology
    • Neurology
    • Pain Medicine

    Background:

    • Eye pain is a frequent and challenging clinical complaint.
    • Many painful ocular conditions lack obvious neurological examination findings.

    Purpose of the Study:

    • To review common and challenging painful eye conditions encountered in clinical practice.
    • To emphasize conditions that may not present with clear neurological signs.

    Main Methods:

    • Review of current literature on ocular pain.
    • Synthesis of information on primary and secondary headache disorders manifesting as eye pain.
    • Categorization of ophthalmic conditions causing eye pain.

    Main Results:

    • Chronic neuropathic ocular pain is linked to central and peripheral sensitization.
    • Dry eye disease is associated with hyperalgesia.
    • Giant cell arteritis affects the aorta and its branches in 25% of patients.

    Conclusions:

    • Eye pain evaluation requires careful consideration of diverse etiologies.
    • Primary headache disorders (e.g., migraine) and secondary causes (e.g., aneurysms, Tolosa-Hunt syndrome) can cause eye pain.
    • Ophthalmic conditions, particularly corneal diseases, are common sources of eye pain.