Patients with more severe symptoms of neuropathic ocular pain report more frequent and severe chronic overlapping pain conditions and psychiatric disease

Crane, Ashley M.; Levitt, Roy C.; Felix, Elizabeth R.; Sarantopoulos, Konstantinos D.; McClellan, Allison L.; Galor, Anat

doi:10.1136/bjophthalmol-2015-308214

Cited by 69 publications

(51 citation statements)

References 42 publications

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“…This study included mild and moderate DE participants (OSDI scores between 12.5 and 31.8) and the results should not be extended to more advanced disease states. In fact, recent data on ocular surface pain suggest that the ocular surface of severe DE patients may respond differently from ocular stimulation than milder forms of the disease …”

Section: Discussionmentioning

confidence: 99%

“…The pathways of ocular pain are not well understood; however, it is believed that sensory pathways are altered (neuropathic pain), especially in more severe cases of the disease . The area of neuropathic pain in the eye is rapidly evolving and it has been suggested that those suffering from it also report more chronic and severe pain in other areas of the body . Future studies may take this into consideration when assessing different states of DE disease severity.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Does the temperature of an artificial tear affect its comfort?

Bitton

Crncich²,

Brunet³

2018

Clinical and Experimental Optometry

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Does the temperature of an artificial tear affect its comfort?

Bitton

Crncich²,

Brunet³

2018

Clinical and Experimental Optometry

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“…The association of DED with CPS has been suggested 13,65–67. Vehof et al67 showed a close relationship between DED and chronic widespread pain syndrome.…”

Section: Association With Neurological Problemsmentioning

confidence: 99%

Association of dry eye disease with psychiatric or neurological disorders in elderly patients

Han

Yang²,

Hyon³

et al. 2017

CIA

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Dry eye disease (DED) is a common disease that can impair quality of life significantly. Its prevalence increases with advancing age, and the economic burden of the disease on both a patient and the society is increasing with elongation of life expectancy. The diagnosis and treatment of DED are often difficult due to the discordance between symptoms and signs of the disease. Recent studies have suggested the role of neurological or psychological factors in the development of dry eye symptoms and discrepancy of the symptoms and signs, particularly in elderly patients. In this review, the authors discuss the association of DED with various psychiatric and neurological disorders. In addition to psychiatric conditions, including depression, anxiety, stress, posttraumatic stress disorder and sleep disorders, medications for the psychiatric disorders have association with DED. Neurological disorders, such as neuropathic pain, chronic pain syndrome, peripheral neuropathy and several central nervous system disorders, are related to DED. Treatment of DED, combined with psychiatric or neurological disorders, is also discussed. Attention should be paid to the DED patients with discordant symptoms and signs, and unsatisfactory response to conventional treatment for associated psychiatric or neurological disorders, as well as an integrated treatment approach, could be helpful for these patients.

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“…4,13 Additional underlying causes include DED, infectious keratitis, recurrent erosions, radiation keratopathy, contact lens wear, and many others as summarized in Table 1. Important co-morbid conditions include, anxiety, 23,24 depression, 23–25 and post-traumatic stress disorders. 23,24 …”

Section: Pathophysiology Of Neuropathic Corneal Painmentioning

confidence: 99%

“…Important co-morbid conditions include, anxiety, 23,24 depression, 23–25 and post-traumatic stress disorders. 23,24 …”

Section: Pathophysiology Of Neuropathic Corneal Painmentioning

confidence: 99%

Neuropathic Corneal Pain

2017

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Neuropathic pain is caused by a primary lesion or dysfunction of the nervous system and can occur in the cornea. However, neuropathic corneal pain (NCP) is currently an ill-defined disease. Patients with NCP are extremely challenging to manage and evidence-based clinical recommendations for the management of patients with NCP are scarce. The objectives of this review are to provide guidelines for diagnosis and treatment of patients with NCP and to summarize current evidence-based literature in this area. We performed a systematic literature search of all relevant publications between 1966 and 2017. Treatment recommendations are, in part, based on methodologically sound randomized controlled trials (RCTs), demonstrating superiority to placebo or relevant control treatments, and on the consistency of evidence, degree of efficacy, and safety. In addition, the recommendations include our own extensive experience in the management of these patients over the past decade. A comprehensive algorithm, based on clinical evaluation and complementary tests, is presented for diagnosis and subcategorization of patients with NCP. Recommended first-line topical treatments include neuro-regenerative and anti-inflammatory agents, whilst first-line systemic pharmacotherapy includes tricyclic antidepressants and the anticonvulsant. Second line oral treatments recommended include the opioid-antagonist and opiate analgesics. Complementary and alternative treatments, such as cardio-exercise, acupuncture, omega-3 fatty acid, and gluten-free diet, may have additional benefits, as do potential non-invasive and invasive procedures in recalcitrant cases. Medication selection should be tailored on an individual basis, considering side effects, comorbidities, and levels of peripheral and centralized pain. Nevertheless, there is an urgent need for long-term studies and RCTs assessing the efficacy of treatments for NCP.

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Patients with more severe symptoms of neuropathic ocular pain report more frequent and severe chronic overlapping pain conditions and psychiatric disease

Cited by 69 publications

References 42 publications

Does the temperature of an artificial tear affect its comfort?

Does the temperature of an artificial tear affect its comfort?

Association of dry eye disease with psychiatric or neurological disorders in elderly patients

Neuropathic Corneal Pain

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