Factors affecting the prevalence, severity, and characteristics of ocular surface pain. (2nd January 2023)

• Record Type: Journal Article
• Authors: Sanchez, Victor; Cohen, Noah K; Felix, Elizabeth R; Galor, Anat
• Is Part Of: Expert review of ophthalmology. Volume 18:Number 1(2023)
• Page Start: 19
• Page End: 32
• Publication Date: 2023-01-02
• Subjects: Ocular surface pain -- pain -- dry eye -- neuropathic pain -- nociceptive pain -- nerve sensitization -- hyperalgesia; Ophthalmology -- Periodicals; 617.7005
• DOI: 10.1080/17469899.2023.2157813
• Languages: English
• ISSNs: 1746-9899

Abstract

ABSTRACT: Introduction: Ocular surface pain has been traditionally lumped under the umbrella term 'dry eye' (DE) but is now understood as its own entity and can occur in the absence or presence of tear dysfunction. Identifying patients at risk for the development of chronic ocular surface pain, and factors contributing to its severity are important in providing precision medicine to patients. Areas covered: In this review, we discuss factors linked to the presence and severity of ocular surface pain, including eye-related features, systemic characteristics, and environmental findings. We discuss corneal nerves, whose anatomic and functional integrity can be characterized through in vivo confocal microscopy images and testing of corneal sensitivity. We review systemic diseases that are comorbid with ocular surface pain, including physical and mental health diagnoses. Finally, we identify environmental contributors, including air pollution, previous surgeries, and medications, associated with ocular surface pain. Expert opinion: Intrinsic and extrinsic factors contribute to ocular surface pain and must be considered when evaluating an individual patient. These factors can inform the suspected etiology of the pain, and guide management decisions such as tear replacement or medications targeting nerve pain.