The Painful Eye

Dargin, James; Lowenstein, Robert A.

doi:10.1016/j.emc.2007.10.001

Cited by 35 publications

(19 citation statements)

References 36 publications

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“…Increased hydrostatic pressure in the cystic lesions, where glands cannot excrete their fluid to the uterine cavity, as they normally do, is presumably involved in the mechanical hyperalgesia observed at these time points. Painful symptoms associated with such an increased pressure are also observed in abscesses (Kessler et al, 2012), dental pulpitis (Heyeraas and Berggreen, 1999), acute glaucoma (Dargin and Lowenstein, 2008) or benign intracranial hypertension (Galgano and Deshaies, 2013), which are also readily responsive to appropriate drainage interventions. Importantly, pro-algesic inflammatory mediators are known to be present in the fluid in endometriotic cysts (Darai et al, 2003; Zhang et al, 2008), suggesting that the effect of drainage is due to the decompression of a structure innervated by sensitized nociceptors.…”

Section: Discussionmentioning

confidence: 99%

Impact of surgical excision of lesions on pain in a rat model of endometriosis

Álvarez

Giudice

Levine

2014

European Journal of Pain

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Background Chronic pain is the most common and disabling feature of endometriosis. Surgical excision of endometriosis lesions provides relief but pain relapse is common. Studies in a preclinical model of endometriosis might help to unravel the role of the ectopic lesions as the source of pain. Thus, we evaluated the impact of lesion excision on mechanical hyperalgesia in a preclinical model of endometriosis pain. Methods Endometriosis was induced by implanting autologous uterine tissue onto the gastrocnemius muscle. Surgical excision or aspiration drainage of the cystic lesion was performed at different times post-implant and mechanical nociceptive thresholds assessed at the site of the lesion. Results Lesions at 2, 8 and 16 weeks post-implant, produced mechanical hyperalgesia of similar magnitude (n = 6/group). Excision of lesions (n = 6/group) produced a longer inhibition, with a magnitude and time-course depending on the timing of excision. Excision at 2 and 8 weeks produced a rapid onset marked attenuation of hyperalgesia, which returned to pre-excision values by postsurgical week 3. In contrast, excision of the lesion at 16 weeks produced a peak of inhibition of hyperalgesia 2 weeks post-excision, but then the inhibition was sustained. Aspiration of fluid from cysts in the lesions briefly attenuated mechanical hyperalgesia (n = 6/group). Conclusions In this preclinical model we demonstrate that endometriosis pain is alleviated by surgical excision of the ectopic lesion or drainage of its cysts, providing support for the clinical observation that endometriosis pain is dependent on the ongoing presence of the lesions.

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Section: Discussionmentioning

confidence: 99%

Impact of surgical excision of lesions on pain in a rat model of endometriosis

Álvarez

Giudice

Levine

2014

European Journal of Pain

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“…Previous recording studies, based mainly on response properties in naïve rats (Hirata et al, 1999; Hirata et al, 2000; Hirata et al, 2004; Meng et al, 1997; Meng et al, 1998), have led to the proposal that neurons at the Vi/Vc transition and in the superficial laminae at the Vc/C1 region serve different aspects of trigeminal function in ocular pain (Bereiter et al, 2000). Although ocular inflammation is a common clinical problem that causes pain and can develop from a variety of conditions such as refractive surgery, infection or trauma (Dargin and Lowenstein, 2008; Leibowitz, 2000), most animal models of ocular pain have been relied on approaches that involve direct nerve damage (see Belmonte et al, 2004; Wenk and Honda, 2003). Recently we reported that endotoxin-induced uveitis (EIU), an animal model that mimics some of the early signs of anterior uveitis in humans, produced time-dependent changes in responsiveness of neurons in the caudal trigeminal sensory brainstem complex (Bereiter et al, 2005).…”

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confidence: 99%

Behavioral and neurophysiological correlates of nociception in an animal model of photokeratitis

et al. 2010

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Ocular exposure to ultraviolet irradiation (UVR) induces photokeratitis, a common environmental concern that inflames ocular tissues and causes pain. The central neural mechanisms that contribute to the sensory aspects of photokeratitis after UVR are not known. In awake male rats, ocular surface application of hypertonic saline evoked eye wipe behavior that was enhanced 2-3 days after UVR and returned to control levels by 7 days. Similarly, under isoflurane anesthesia, hypertonic saline-evoked activity of ocular neurons in superficial laminae at the trigeminal subnucleus caudalis/cervical (Vc/C1) region was enhanced 2 days, but not 7 days, after UVR. By contrast, the response of neurons at the interpolaris/caudalis (Vi/Vc) transition region to hypertonic saline was not affected by UVR. The background activity and convergent cutaneous receptive field areas of Vc/C1 or Vi/Vc neurons were not affected by UVR. Aqueous humor protein levels were elevated 2 and 7 days after UVR.UVR enhanced nociceptive behavior, after a latent period, with a time course similar to that of ocular neurons in superficial laminae at the Vc/C1 region. The Vc/C1 region plays a key role in primary hyperalgesia induced by UVR, while the Vi/Vc region likely mediates other aspects of ocular function. Keywords eye wipe behavior; inflammation; ocular pain; trigeminal subnucleus caudalis; UV irradiationThe eye is vulnerable to most forms of radiant energy. Exposure to ultraviolet irradiation (UVR) is particularly harmful and nearly all short wavelength (UVA, below 280 nm) and middle wavelength (UVB, 280-320 nm) UVR is absorbed by the cornea and other compartments of the anterior eye segment (Sliney, 2002). Solar energy is the main environmental source of UVA and UVB irradiation for most individuals; however, artificial sources from arc welding and tanning salons also contribute (Rieke, 1943;Tenkate, 1999). Photokeratitis is the major clinical condition following acute exposure to UVR and is characterized by anterior eye segment inflammation, reduced visual acuity and burning-like pain of the ocular surface that develops slowly over several hours (Schein, 1992;Cullen, 2002 Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptNeuroscience. Author manuscript; available in PMC 2011 August 11. animal studies have focused on peripheral histological and biochemical aspects of UVRinduced damage to the anterior eye segment (Bergmanson, 1990; Doughton and Cullen, 1989;Zuclich, 1989), while less is known concerning the behavioral and central neural correlates of this injury.The oc...

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“…Optic neuritis is another cause of painful monocular visual loss but without a red eye 14. Occasionally, acute close angle glaucoma might present without pain 15…”

Section: Discussionmentioning

confidence: 99%

Sudden loss of vision in a patient with significant ipsilateral internal carotid disease

Huwez

Umasankar²,

Casswell³

et al. 2011

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A 74-year-old man developed sudden onset of painless persistent partial loss of vision in the right eye 3 days after right total knee replacement. The initial investigation was for amaurosis fugax with a normal CT scan of the brain but the carotid Doppler confirmed >90% stenosis of the right internal carotid artery. Urgent ophthalmological review confirmed anterior ischaemic optic neuropathy. Subsequently, he lost his vision completely in the right eye. He had a previous high risk hemispheric transient ischaemic attack with carotid Doppler reported as normal.

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The Painful Eye

Cited by 35 publications

References 36 publications

Impact of surgical excision of lesions on pain in a rat model of endometriosis

Impact of surgical excision of lesions on pain in a rat model of endometriosis

Behavioral and neurophysiological correlates of nociception in an animal model of photokeratitis

Sudden loss of vision in a patient with significant ipsilateral internal carotid disease

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