Ocular neuropathic pain is suspected when dry eye symptoms are more extreme and heightened relative to their dry eye signs. It can be due to a hypersensitization of the corneal nerves or due to a central nervous system anomaly. Common causes for neuropathic pain include, but are not limited to LASIK, cataract surgery, blepharoplasty, diabetes and fibromyalgia. When neuropathic pain is present, what would feel like mild dry eye to most patients, can feel like severe, debilitating dry eye due to the hypersensitization.
When we see patients with ocular neuropathic pain , they usually mention that they have seen many eye doctors and have tried everything to treat their dry eye but the symptoms are still very bothersome. Neuropathic dry eye management typically involves improving corneal nerve integrity. When a central nervous system anomaly is suspected to be causing the ocular neuropathic pain, management with a pain specialist is typically required.