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Ocular Neuropathic Pain: An Overview Focusing on Ocular Surface Pains
Nazanin Ebrahimiadib1, Fardin Yousefshahi2, Parisa Abdi1
1Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Clinical Ophthalmology (Auckland, N.Z.)
|October 16, 2020
Summary
Ocular pain, particularly dry eye pain, can stem from neuropathic origins. Understanding ocular neuropathic pain syndrome is crucial for effective treatment beyond conventional methods.
Area of Science:
- Ophthalmology
- Neuroscience
- Pain Medicine
Background:
- Ocular pain is a common complaint, often focusing on ocular surface discomfort and dry eye.
- Pain can be classified as acute or chronic, nociceptive or neuropathic, with chronic pain frequently having a neuropathic component.
Purpose of the Study:
- To review the current understanding of ocular pain, with a specific emphasis on ocular surface discomfort and dry eye pain.
- To explore the anatomy, physiology, epidemiology, assessment, and treatment of ocular pain.
Main Methods:
- A comprehensive literature search was performed using PubMed for studies published between 2000 and 2019.
- Inclusion criteria focused on ocular surface discomfort, dry eye pain, and neuropathic pain, including reviews, meta-analyses, and randomized clinical trials.
Main Results:
- 112 articles were identified through the search.
- 45 articles were selected for in-depth review and analysis.
Conclusions:
- Ocular surface pain, especially post-corneal surgery, may involve abnormal corneal nerve regeneration and spontaneous activity, suggesting neuropathic origins.
- The concept of ocular neuropathic pain syndrome is proposed, necessitating consideration of treatments used for neuropathic pain elsewhere.
- Management involves addressing tear insufficiency, lid/blinking issues, inflammation, and potentially systemic neuromodulators for resistant cases.
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