Corneal sensitivity in dry eye disease: A systematic review

Area of Science:

• Ophthalmology
• Neuroscience
• Corneal Research

Background:

• Dry eye disease (DED) is a prevalent global condition with poorly understood pathophysiology.
• Corneal nerves are crucial in DED, necessitating research into their functional and morphological alterations.
• Understanding corneal nerve function is vital for advancing DED diagnosis and treatment.

Purpose of the Study:

• To systematically review and investigate changes in corneal nerve function in patients with dry eye disease.
• To synthesize findings on corneal sensitivity alterations in DED from existing literature.

Main Methods:

• A systematic literature search was conducted in PubMed, Web of Science, and Scopus up to September 10, 2025, adhering to PRISMA guidelines.
• Included studies measured corneal sensitivity in DED patients and healthy controls.
• Publication selection and data analysis were performed independently by two researchers.

Main Results:

• Twenty-five studies (1580 participants) were included; 19 used Cochet-Bonnet aesthesiometry, consistently showing reduced corneal sensitivity in DED patients.
• No clear correlation between corneal sensitivity and DED severity was found, likely due to study heterogeneity.
• Air jet aesthesiometry yielded inconsistent results for mechanical sensitivity, with some studies reporting increased sensitivity at ambient temperature.

Conclusions:

• Cochet-Bonnet measurements indicate decreased mechanical corneal sensitivity in DED.
• Inconsistent findings from air jet aesthesiometry suggest varied responses from different corneal nerve endings.
• Standardized study designs and reliable measurement methods are crucial for future research on corneal sensitivity in DED.