Chronic Ocular Surface Pain: An Optometrist and Ophthalmologist Survey

Chronic ocular surface pain (COSP) is defined as ocular pain that is perceived to originate from the ocular surface and persists for more than 3 months. Clear epidemiological data on COSP prevalence are lacking.

In 2025, a total of 100 eye care providers were surveyed, including 50 optometrists and 50 ophthalmologists. The survey aimed to assess the percentage of their weekly patient volume diagnosed with COSP, the diagnostic methods used, contributing etiologies, and current management strategies. Additionally, practitioners identified key indicators of successful treatment and attributes they believed would have the greatest impact on patient outcomes. Lastly, they rated their satisfaction with current therapeutic options.

An estimated 33% of optometrists' patients and 29% of ophthalmologists' patients had COSP. Of those diagnosed with dry eye disease (DED), 63% also had COSP. Providers managed COSP with over-the-counter (OTC) artificial tears (97% of respondents), OTC gels and ointments (90%), hot compresses (86%), and prescription therapies indicated for DED (30-88%), while a minority routinely used amniotic membranes (37%), serum tears (26%), intense pulsed light (18%), and LipiFlow (16%). The proportions of providers who were satisfied or very satisfied with these therapies were as follows: 64% for amniotic membranes and serum tears, 63% for device-based therapies, 40% for prescription medications, and 21% for OTC drops, ointments, and hot compresses.

This survey provides initial insight into the prevalence of COSP among patients in US eye care clinics, along with perspectives on managing this condition from both optometrists and ophthalmologists. The most common therapeutic strategies for COSP (OTC artificial tears, gels, and ointments) were associated with the lowest levels of provider satisfaction. COSP and dry eye disease are distinct but closely linked conditions. These results demonstrate an unmet need for new treatment options to address COSP.