Noninvasive Electrical Stimulation for the Treatment of Chronic Ocular Pain and Photophobia

Sivanesan, Eellan; Levitt, Roy C.; Sarantopoulos, Constantine; Patin, Dennis

doi:10.1111/ner.12742

Cited by 29 publications

(25 citation statements)

References 60 publications

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“…gabapentin), 2 , 4 and stimulation therapies. 17 , 18 In this case report, we describe the therapeutic potential of sensory peripheral nerve blocks and discuss possible mechanisms for their effect on eye pain.…”

Section: Introductionmentioning

confidence: 99%

Resolution of pain with periocular injections in a patient with a 7-year history of chronic ocular pain

Duerr

Chang

Venkateswaran

et al. 2019

American Journal of Ophthalmology Case Reports

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Purpose We report a case of a male patient with chronic ocular pain that resolved completely following peripheral nerve blocks. Observations A 66-year-old male presented with a seven-year history of severe left eye pain and photophobia. The pain began after retinal detachment repair with scleral buckle placement. Previous treatments included topical (autologous serum tears, corticosteroids, diclofenac, cyclosporine) and oral (gabapentin, diclofenac) therapies with no pain relief. The patient's pain was so severe that he requested enucleation. After discussion, the decision was made to perform periocular nerve blocks. Prior to the procedure, the patient reported an average pain intensity of 8 out of 10 and photophobia daily. Following left supraorbital, supratrochlear, infraorbital and infratrochlear injections with bupivacaine and methylprednisolone, pain intensity and photophobia improved to 1–2 out of 10. One week later, repeat infraorbital and infratrochlear nerve blocks were given, after which time the patient reported complete resolution of symptoms that lasted for 7 months. Repeat nerve blocks were administered with repeat resolution of pain. There were no complications associated with the procedures. Conclusions and Importance Chronic ocular pain can be a debilitating condition. Periorbital nerve blocks can provide pain relief and should be considered as a potential treatment option after medical management has failed.

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Section: Introductionmentioning

confidence: 99%

Resolution of pain with periocular injections in a patient with a 7-year history of chronic ocular pain

Duerr

Chang

Venkateswaran

et al. 2019

American Journal of Ophthalmology Case Reports

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“…During medical procedures, it was not considered practical to only treat patients with TES without artificial tears as most patients were unwilling to receive TES treatment only without eye drops. Sivanesan et al (7) found that the non-invasive electrical stimulation of the trigeminal nerve achieved a short-term reduction in DE-related chronic ocular pain and photophobia. The use of TENS reduced pain intensity in both eyes by a mean of 57% and decreased light sensitivity by 27-28%.…”

Section: Discussionmentioning

confidence: 99%

“…The first hypothesis is that TES can effectively stimulate the trigeminal nerve to relieve DE symptoms such as pain and photophobia (7,29); this hypothesis may account for OSDI results. Previous studies reported that the mechanism of TES for DE may be associated with the modulation of neuroanatomical pain pathways within the trigeminal system (22,30,31).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, a number of patients report less improvement in chronic ocular pain and photophobia with topical therapies (6). Evaluating the potential of low-risk adjuvant treatments in these patients has been attracting increasing interest (7).…”

Section: Introductionmentioning

confidence: 99%

“…It is a non-invasive form of neuromodulation that has demonstrated effectiveness in numerous pain conditions and has been widely used over recent decades (12)(13)(14)(15). TES also has been used for treating ocular diseases with promising results (7,16,17).…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of transcutaneous electrical stimulation combined with artificial tears for the treatment of dry eye: A randomized controlled trial

Cai¹,

Zhang²

2020

Exp Ther Med

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There is currently no available cure or universally effective treatment for dry eye (DE). The aim of the present study was to investigate the clinical efficacy of transcutaneous electrical stimulation (TES) combined with artificial tears in treating DE. Patients diagnosed with DE were referred for therapy with TES combined with sodium hyaluronate (SH)-containing artificial tears. A total of 52 patients (104 eyes) with DE were enrolled in this randomized controlled trial. The patients were randomized 1:1 to the TES + SH or SH group. The patients in the TES + SH group were treated with 20 sessions (5 sessions per week for 4 weeks), and each session lasted for 20 min. The treatment was continued for 4 weeks in all cases. The Ocular Surface Disease Index (OSDI), tear film breakup time (BUT), Schirmer's I test and corneal fluorescein scores were used to assess treatment efficacy. A total of 90 eyes of 45 patients completed all aspects of the study: 22 patients (44 eyes) in the TES + SH group and 23 patients (46 eyes) in the SH group. There was no statistically significant difference in sex, age or course between the two groups. The mean OSDI scores, BUT, Schirmer's I test and corneal fluorescein scores exhibited a significant improvement in the TES + SH group compared with the SH group after treatment. No serious adverse events were recorded during TES treatment. In conclusion, TES combined with artificial tears appeared to be an effective treatment for DE. Therefore, TES may represent a new therapeutic option with promising potential applications.

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A Microfluidic Contact Lens to Address Contact Lens‐Induced Dry Eye

Zhu

Nasiri

Davoodi

et al. 2022

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The contact lens (CL) industry has made great strides in improving CLwearing experiences. However, a large amount of CL wearers continue to experience ocular dryness, known as contact lens-induced dry eye (CLIDE), stemming from the reduction in tear volume, tear film instability, increased tear osmolarity followed by inflammation and resulting in ocular discomfort and visual disturbances. In this article, to address tear film thinning between the CL and the ocular surface, the concept of using a CL with microchannels to deliver the tears from the pre-lens tear film (PrLTF) to the post-lens ocular surface using in vitro eye-blink motion is investigated. This study reports an eye-blink mimicking system with microfluidic poly(2-hydroxyethyl methacrylate) (poly(HEMA)) hydrogel with integrated microchannels to demonstrate eye-blink assisted flow through microchannels. This in vitro experimental study provides a proof-of-concept result that tear transport from PrLTF to post-lens tear film can be enhanced by an artificial eyelid motion in a pressure range of 0.1-5 kPa (similar to human eyelid pressure) through poly(HEMA) microchannels. Simulation is conducted to support the hypothesis. This work demonstrates the feasibility of developing microfluidic CLs with the potential to help prevent or minimize CLIDE and discomfort by the enhanced transport of pre-lens tears to the post-lens ocular surface.

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Noninvasive Electrical Stimulation for the Treatment of Chronic Ocular Pain and Photophobia

Cited by 29 publications

References 60 publications

Resolution of pain with periocular injections in a patient with a 7-year history of chronic ocular pain

Resolution of pain with periocular injections in a patient with a 7-year history of chronic ocular pain

Effectiveness of transcutaneous electrical stimulation combined with artificial tears for the treatment of dry eye: A randomized controlled trial

A Microfluidic Contact Lens to Address Contact Lens‐Induced Dry Eye

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