Ocular Neuropathic Pain: An Overview Focusing on Ocular Surface Pains

Nazanin Ebrahimiadib,1 Fardin Yousefshahi,2 Parisa Abdi,1 Mohammadreza Ghahari,1 Bobeck S Modjtahedi3– 5 1Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Anesthesiology, Pain and Critical Care, Tehran University of Medical Sciences, Tehran, Iran; 3D...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Ebrahimiadib N, Yousefshahi F, Abdi P, Ghahari M, Modjtahedi BS
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	ocular pain dry eye neuropathic pain Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/6613da1e009f4ff6ad607052d16603e9
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:6613da1e009f4ff6ad607052d16603e9
record_format	dspace
spelling	oai:doaj.org-article:6613da1e009f4ff6ad607052d16603e92021-12-02T10:30:22ZOcular Neuropathic Pain: An Overview Focusing on Ocular Surface Pains1177-5483https://doaj.org/article/6613da1e009f4ff6ad607052d16603e92020-09-01T00:00:00Zhttps://www.dovepress.com/ocular-neuropathic-pain-an-overview-focusing-on-ocular-surface-pains-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Nazanin Ebrahimiadib,1 Fardin Yousefshahi,2 Parisa Abdi,1 Mohammadreza Ghahari,1 Bobeck S Modjtahedi3– 5 1Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Anesthesiology, Pain and Critical Care, Tehran University of Medical Sciences, Tehran, Iran; 3Department of Ophthalmology, Southern California Permanent Medical Group, Baldwin Park, CA, USA; 4Eye Monitoring Center, Kaiser Permanent Southern California, Baldwin Park, CA, USA; 5Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, CACorrespondence: Parisa AbdiFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran, IranEmail paris.abdi@gmail.comObjective: This paper reviews ocular pain with the main focus on ocular surface discomfort and dry eye pain. Anatomy, physiology, epidemiology, assessment, and treatment are discussed in this paper.Methods: A PubMed search was conducted for studies published from 2000 to 2019 on the anatomy, pathophysiology, epidemiology, assessment, and treatment of ocular pain. Reviews, meta-analyses, and randomized clinical trials were included. Inclusion criteria focused on ocular surface discomfort, dry eye pain and neuropathic pain.Results: A total of 112 articles were found through searches, 45 of which were selected and studied in this review.Discussion: Pain in general can be acute or chronic. Acute pain is usually a physiologic response to a serious damage to the tissues and alleviates with pain relief treatments. Chronic pain is defined as the persistence of pain for more than three months. From another point of view, pain has been classified into either nociceptive or neuropathic. Nociceptive pain is a physiologic response to a noxious stimulus. Both central and peripheral nervous systems can be involved in the development of a neuropathic pain, which is characterized by positive or negative sensory signs, a pain perceived disproportionate to a noxious stimulus, and/or not responsive to analgesics. Chronic pain usually has a neuropathic component. Ocular surface pain is a well-known complaint after any corneal surgery. This is mainly due to abnormal regeneration of damaged corneal nerve endings and abnormal connections with adjacent nerve endings which produce spontaneous activity. Tear hyperosmolarity and the resultant ocular surface inflammation can also trigger voluntary activity of corneal nerve endings. Referral pain to the first and second division of the trigeminal nerve has been reported. Interference with vision and even sleep, which is out of proportion to the examination are among patients’ complaints. All of these elements proposed the new concept of ocular neuropathic pain syndrome. The first step in conventional evaluation of ocular discomfort is search for tear insufficiency. Pathologies of lid and blinking as well as conjunctival irregularities should be addressed. Anti-inflammatory agents and, in resistant cases, systemic neuromodulators are shown to be helpful. Education on behavioral changes and reassurance are essential steps. Considering the neuropathic origin for the ocular pain, treatment modalities used for such pain in other parts of the body can be considered for this syndrome.Keywords: ocular pain, dry eye, neuropathic painEbrahimiadib NYousefshahi FAbdi PGhahari MModjtahedi BSDove Medical Pressarticleocular paindry eyeneuropathic painOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 2843-2854 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	ocular pain dry eye neuropathic pain Ophthalmology RE1-994
spellingShingle	ocular pain dry eye neuropathic pain Ophthalmology RE1-994 Ebrahimiadib N Yousefshahi F Abdi P Ghahari M Modjtahedi BS Ocular Neuropathic Pain: An Overview Focusing on Ocular Surface Pains
description	Nazanin Ebrahimiadib,1 Fardin Yousefshahi,2 Parisa Abdi,1 Mohammadreza Ghahari,1 Bobeck S Modjtahedi3– 5 1Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Anesthesiology, Pain and Critical Care, Tehran University of Medical Sciences, Tehran, Iran; 3Department of Ophthalmology, Southern California Permanent Medical Group, Baldwin Park, CA, USA; 4Eye Monitoring Center, Kaiser Permanent Southern California, Baldwin Park, CA, USA; 5Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, CACorrespondence: Parisa AbdiFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran, IranEmail paris.abdi@gmail.comObjective: This paper reviews ocular pain with the main focus on ocular surface discomfort and dry eye pain. Anatomy, physiology, epidemiology, assessment, and treatment are discussed in this paper.Methods: A PubMed search was conducted for studies published from 2000 to 2019 on the anatomy, pathophysiology, epidemiology, assessment, and treatment of ocular pain. Reviews, meta-analyses, and randomized clinical trials were included. Inclusion criteria focused on ocular surface discomfort, dry eye pain and neuropathic pain.Results: A total of 112 articles were found through searches, 45 of which were selected and studied in this review.Discussion: Pain in general can be acute or chronic. Acute pain is usually a physiologic response to a serious damage to the tissues and alleviates with pain relief treatments. Chronic pain is defined as the persistence of pain for more than three months. From another point of view, pain has been classified into either nociceptive or neuropathic. Nociceptive pain is a physiologic response to a noxious stimulus. Both central and peripheral nervous systems can be involved in the development of a neuropathic pain, which is characterized by positive or negative sensory signs, a pain perceived disproportionate to a noxious stimulus, and/or not responsive to analgesics. Chronic pain usually has a neuropathic component. Ocular surface pain is a well-known complaint after any corneal surgery. This is mainly due to abnormal regeneration of damaged corneal nerve endings and abnormal connections with adjacent nerve endings which produce spontaneous activity. Tear hyperosmolarity and the resultant ocular surface inflammation can also trigger voluntary activity of corneal nerve endings. Referral pain to the first and second division of the trigeminal nerve has been reported. Interference with vision and even sleep, which is out of proportion to the examination are among patients’ complaints. All of these elements proposed the new concept of ocular neuropathic pain syndrome. The first step in conventional evaluation of ocular discomfort is search for tear insufficiency. Pathologies of lid and blinking as well as conjunctival irregularities should be addressed. Anti-inflammatory agents and, in resistant cases, systemic neuromodulators are shown to be helpful. Education on behavioral changes and reassurance are essential steps. Considering the neuropathic origin for the ocular pain, treatment modalities used for such pain in other parts of the body can be considered for this syndrome.Keywords: ocular pain, dry eye, neuropathic pain
format	article
author	Ebrahimiadib N Yousefshahi F Abdi P Ghahari M Modjtahedi BS
author_facet	Ebrahimiadib N Yousefshahi F Abdi P Ghahari M Modjtahedi BS
author_sort	Ebrahimiadib N
title	Ocular Neuropathic Pain: An Overview Focusing on Ocular Surface Pains
title_short	Ocular Neuropathic Pain: An Overview Focusing on Ocular Surface Pains
title_full	Ocular Neuropathic Pain: An Overview Focusing on Ocular Surface Pains
title_fullStr	Ocular Neuropathic Pain: An Overview Focusing on Ocular Surface Pains
title_full_unstemmed	Ocular Neuropathic Pain: An Overview Focusing on Ocular Surface Pains
title_sort	ocular neuropathic pain: an overview focusing on ocular surface pains
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/6613da1e009f4ff6ad607052d16603e9
work_keys_str_mv	AT ebrahimiadibn ocularneuropathicpainanoverviewfocusingonocularsurfacepains AT yousefshahif ocularneuropathicpainanoverviewfocusingonocularsurfacepains AT abdip ocularneuropathicpainanoverviewfocusingonocularsurfacepains AT ghaharim ocularneuropathicpainanoverviewfocusingonocularsurfacepains AT modjtahedibs ocularneuropathicpainanoverviewfocusingonocularsurfacepains
_version_	1718397169944231936

Ocular Neuropathic Pain: An Overview Focusing on Ocular Surface Pains

Ejemplares similares