Ocular Surface Pain

Ocular surface pain was originally placed under the umbrella term “dry eye” (DE) but is now recognized as its own entity, with tear film abnormalities as one of many potential contributors to patient symptoms. This is an important problem to tackle as ocular surface pain is estimated to affect 5% to 50% of US and international populations, depending on the definition of symptoms and the population studied. Furthermore, ocular surface pain leads to significant morbidity, with negative impacts on mental health and the ability to work. This book examines the many contributors to ocular surface pain, with a focus on diagnostic pathways and individualized treatment plans. In short, ocular surface pain should be evaluated considering potential nociceptive and neuropathic etiologies, as this approach can aid in developing an individualized intervention plan. Nociceptive pain refers to direct activation of sensory pain fibers due to damage to non-neural tissue. In the eye, many nociceptive triggers such as trauma, low tear production, or surgery can lead to nociceptive ocular surface pain. Neuropathic pain is caused by a lesion or disease affecting the somatosensory pathway. Maladaptive healing after trauma or surgery, or prolonged nociceptive triggers (e.g., aqueous tear deficiency, ocular surface inflammation) can lead to peripheral and/or central nerve abnormalities that manifest with persistent ocular surface pain. However, the two entities are not mutually exclusive. Ocular Surface Pain is a must-have resource for ophthalmologists as well as physicians and specialists in the fields of neurology, psychiatry, rheumatology, and optometry.