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 Kim,Kyung Chul Yoon,Hyeon Jeong Yoon,In Cheon You,Byung Yi Ko

doi:10.1186/s12886-020-01733-1

Abstract

BackgroundTo 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).MethodsCross-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.ResultsNo 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).ConclusionsPatients 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.

Highlights

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)
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
On the basis of the proparacaine challenge test results, 17 patients were assigned to the central group and 16 patients to the peripheral group; their mean ages were 59.12 ± 11.58 and 58.13 ± 12.86 years, respectively

Summary

Introduction

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). Topical anesthetic may be insufficient to alleviate pain in patients with centralized ocular neuropathic pain. Crane et al [10] have introduced the proparacaine challenge test which can discriminate if there is a centralized component in ocular pain. Many studies attempted to evaluate patients with ocular neuropathic pain with dry eye related questionnaires, such as the Ocular Surface Disease Index, Dry Eye Questionnaire, and Dry Eye-Related Quality-of-Life Score [13,14,15]. The Ocular Pain Assessment Survey (OPAS) is a validated questionnaire for ocular pain and assesses nonocular pain, quality of life (QoL), aggravating factors and associated factors as well [16]

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Results

Conclusion