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Ocular Neuropathic Pain: A Clinician's Approach.

Deborah S Jacobs1

  • 1Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA.

Eye & Contact Lens
|June 23, 2026
PubMed
Summary
This summary is machine-generated.

Ocular neuropathic pain (ONP) is eye discomfort from nervous system issues. Diagnosis uses clinical history, eye exams, and advanced microscopy, guiding multimodal treatment strategies.

Keywords:
Anesthetic challengeOcular neuropathic painSystemic therapy

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Area of Science:

  • Ophthalmology
  • Neurology
  • Pain Medicine

Background:

  • Ocular neuropathic pain (ONP) involves eye discomfort due to nervous system dysfunction.
  • Distinguishing ONP from other pain types is crucial for effective management.

Purpose of the Study:

  • To define Ocular Neuropathic Pain (ONP).
  • To outline diagnostic approaches for ONP.
  • To discuss treatment modalities for ONP.

Main Methods:

  • Clinical diagnosis based on patient history and eye examination.
  • Anesthetic challenge as a diagnostic tool.
  • In vivo confocal microscopy for supportive diagnostic evidence.

Main Results:

  • ONP is characterized by pain or discomfort projected to the eye.
  • Diagnostic methods help differentiate nociceptive, nociplastic, and neuropathic pain.
  • Multimodal treatment is frequently necessary.

Conclusions:

  • ONP diagnosis is primarily clinical, supported by specific tests.
  • A combination of local and systemic treatments is often required for ONP management.