Should ocular surface pain be considered ‘dry eye’?

Ocular surface pain, previously categorized as “dry eye,” is now recognized as a separate condition that can occur with or without tear dysfunction. It is important to identify patients at risk for chronic ocular surface pain and determine the factors that contribute to its severity. According to a new study, both intrinsic and extrinsic factors should be considered when evaluating patients, as they can help determine the underlying cause of the pain and guide treatment decisions such as tear replacement or nerve pain medications.

Factors related to ocular surface pain include eye-related features, systemic characteristics, and environmental findings. The anatomic and functional integrity of corneal nerves can be characterized through in vivo confocal microscopy images and testing of corneal sensitivity.

Several systemic diseases are co-morbid with ocular surface pain, including physical and mental health diagnoses, and environmental contributors include air pollution, previous surgeries, and medications.

Reference
Sanchez V, Cohen NK, Felix E, et al. Factors affecting the prevalence, severity, and characteristics of ocular surface pain. Expert Rev Ophthalmol. 2023;18(1):19-32. doi: 10.1080/17469899.2023.2157813. Epub 2022 Dec 18. PMID: 37009062; PMCID: PMC10062703.