Clinical characteristics of dry eye with ocular neuropathic pain features: comparison according to the types of sensitiz
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RESEARCH ARTICLE
Open Access
Clinical characteristics of dry eye with ocular neuropathic pain features: comparison according to the types of sensitization based on the Ocular Pain Assessment Survey Jonghwa Kim1, Hyeon Jeong Yoon1, In Cheon You2, Byung Yi Ko3 and Kyung Chul Yoon1*
Abstract Background: To compare the clinical characteristics of dry eye patients with ocular neuropathic pain features according to the types of sensitization based on the Ocular Pain Assessment Survey (OPAS). Methods: Cross-sectional study of 33 patients with dry eye and ocular neuropathic pain features. All patients had a comprehensive ophthalmic assessment including detailed history, the intensity and duration of ocular pain, the tear film, ocular surface, and Meibomian gland examination, and OPAS. Patients with < 50% improvement in pain intensity after proparacaine challenge test were assigned to the central-dominant sensitization group (central group) and those with ≥50% improvement were assigned to the peripheral-dominant sensitization group (peripheral group). All variables were compared between the two groups. Results: No significant differences were observed in age, sex, underlying diseases, history of ocular surgery, duration of ocular pain, tear film, ocular surface and Meibomian gland parameters (all p > 0.05). Ocular pain and non-ocular pain severity and the percentage of time spent thinking about non-ocular pain were significantly higher in the central group than in the peripheral group (all p < 0.05). Central group complained more commonly of a burning sensation than did the peripheral group (p = 0.01). Conclusions: Patients with central-dominant sensitization may experience more intense ocular and non-ocular pain than the others and burning sensation may be a key symptom in those patients. Keywords: Ocular pain, Ocular neuropathic pain, Neuropathic corneal pain, Neuropathic ocular pain, Dry eye, Sensitization
Background Dry eye disease (DED) is a multifactorial disease and the management of DED is often complicated because the disease varies from patients to patients, both in severity * Correspondence: [email protected] 1 Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, South Korea Full list of author information is available at the end of the article
and in character [1]. DEWS II report has classified ocular neuropathic pain as another entity differentiated from DED [2]. However, some studies reported that patients diagnosed with dry eye often describe features of neuropathic pain, including spontaneous pain, dysesthesias, allodynia, and hyperalgesia [3, 4]. It is established that ongoing damage to the corneal surface and nerve endings induced by tear film instability and persistent
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the sour
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