Effect of non-invasive intranasal neurostimulation on tear volume, dryness and ocular pain.

Purpose: To evaluate the effect of one TrueTear session on change in tear volume and symptoms of dryness and ocular pain.

Methods: Retrospective interventional case series of patients seen in a dry eye clinic. Seventy-five individuals underwent an ocular surface examination and one session of neurostimulation.

Pregabalin Failed to Prevent Dry Eye Symptoms after Laser-Assisted in Situ Keratomileusis (LASIK) in a Randomized Pilot Study.

Purpose: Perioperative pregabalin administration has been found to reduce the risk of persistent pain after a variety of surgical procedures. However, this approach has not been tested in relation to eye surgery. As such, the purpose of this study was to evaluate whether perioperative pregabalin can reduce the presence of dry eye (DE) symptoms, including eye pain, six months after laser-assisted in situ keratomileusis (LASIK).

Dysfunctional Coping Mechanisms Contribute to Dry Eye Symptoms.

Dysfunctional coping behaviors, such as catastrophizing, have been implicated in pain severity and chronicity across several pain disorders. However, the impact of dysfunctional coping has not been examined under the context of dry eye (DE). This study evaluates relationships between catastrophizing and measures of DE, including pain severity and pain-related daily interference.

Oral Gabapentinoids and Nerve Blocks for the Treatment of Chronic Ocular Pain.

Purpose: There is a recognition that nerve dysfunction can contribute to chronic ocular pain in some individuals. However, limited data are available on how to treat individuals with a presumed neuropathic component to their ocular pain. As such, the purpose of this study was to examine the efficacy of our treatment approaches to this entity.

Individuals with migraine have a different dry eye symptom profile than individuals without migraine.

Background: Many individuals with migraine report symptoms of dry eye (DE). However, it is not known whether DE profiles are similar between individuals with and without migraine. To bridge this gap, we evaluated symptoms and signs of DE, including symptoms suggestive of nerve dysfunction, in a large group of individuals with DE symptoms, and compared profiles between individuals with migraine and those without migraine or headache.

Modification of the Neuropathic Pain Symptom Inventory for use in eye pain (NPSI-Eye).

Chronic eye pain, which has previously been assumed to be due to ocular surface abnormalities (ie, "dry eye [DE] disease"), has recently garnered attention as a potential indicator of neuropathic ocular pain in some patients. The purpose of this study was to evaluate the psychometric properties of a modified version of the Neuropathic Pain Symptom Inventory in individuals with eye pain (NPSI-Eye). Enrolled participants (n = 397) completed the NPSI-Eye, general pain severity questionnaires, DE symptom report, and psychological health indices.

Resolution of pain with periocular injections in a patient with a 7-year history of chronic ocular pain.

Purpose: We report a case of a male patient with chronic ocular pain that resolved completely following peripheral nerve blocks.

Observations: A 66-year-old male presented with a seven-year history of severe left eye pain and photophobia. The pain began after retinal detachment repair with scleral buckle placement.

Photophobia and sensations of dryness in patients with migraine occur independent of baseline tear volume and improve following botulinum toxin A injections.

Background: To evaluate the efficacy of botulinum toxin A (BoNT-A) in reducing photophobia and dry eye symptoms in individuals with chronic migraine. Additionally, we aimed to evaluate tear film volume as a potential contributor to symptoms in these patients.

Methods: Retrospective review of 76 patients who received BoNT-A for chronic migraine between 23 August 2017 and 13 December 2017 at the Miami Veterans Affairs Medical Center Neurotoxin Clinic.

Epidemiology of Persistent Postsurgical Pain Manifesting as Dry Eye-Like Symptoms After Cataract Surgery.

Purpose: To evaluate the epidemiology of persistent postsurgical pain (PPP) manifesting as dry eye (DE)-like symptoms 6 months after surgery.

Methods: This single-center study included 119 individuals whose cataract surgeries were performed by a single surgeon at the Bascom Palmer Eye Institute and who agreed to participate in a phone survey 6 months after surgery. Patients were divided into 2 groups: the PPP group was defined as those with a Dry Eye Questionnaire-5 score ≥6 and without PPP as those with a Dry Eye Questionnaire-5 score <6 at 6 months after cataract surgery.

Epidemiology of Persistent Dry Eye-Like Symptoms After Cataract Surgery.

Purpose: To evaluate the frequency and risk factors for persistent postsurgical pain (PPP) after cataract surgery, defined as mild or greater dry eye (DE)-like symptoms 6 months after surgery.

Methods: This single-center study included 86 individuals who underwent cataract surgery between June and October 2016 and had DE symptom information available 6 months after surgery. Patients were divided into 2 groups: controls were defined as those without DE symptoms 6 months after surgery (defined by a Dry Eye Questionnaire 5 (DEQ5) score <6), cases were defined as those with mild or greater DE-like symptoms 6 months after surgery (DEQ5 ≥6).

Evidence that dry eye is a comorbid pain condition in a U.S. veteran population.

Introduction: Recent evidence suggests that dry eye (DE) may be comorbid with other chronic pain conditions.

Objectives: To evaluate DE as a comorbid condition in the U.S.

Noninvasive Electrical Stimulation for the Treatment of Chronic Ocular Pain and Photophobia.

Introduction: "Dry eye" or "keratoconjunctivitis sicca" is a multifactorial disease estimated to have a worldwide prevalence of 5-33%. Conventional therapies targeting the ocular surface with artificial tears, anti-inflammatories, punctal closure, eyelid hygiene, and antibiotics do not provide relief in all patients, especially those with neuropathic-like ocular complaints (wind hyperalgesia and photophobia). We anticipated that ocular transcutaneous electrical nerve stimulation (TENS) would alleviate symptoms of ocular pain, photophobia, and dryness in these latter individuals.

Neuropathic-Like Ocular Pain and Nonocular Comorbidities Correlate With Dry Eye Symptoms.

Objective: To evaluate the association between dry eye (DE) symptoms and neuropathic-like ocular pain (NOP) features, chronic pain conditions, depression, and anxiety in patients presenting for routine ophthalmic examinations.

Methods: Two hundred thirty-three consecutive patients ≥18 years of age presenting to a comprehensive eye clinic between January and August 2016 were included in this study. Information on demographics, chronic pain conditions, medication use, DE symptoms (dry eye questionnaire, DEQ5), NOP complaints (burning; wind, light, and temperature sensitivity), depression, and anxiety indices (patient health questionnaire 9, PHQ-9 and symptom checklist 90-revised, SCL-90-R) were collected for each individual.

Traumatic brain injury, dry eye and comorbid pain diagnoses in US veterans.

Aims: The purpose of the study is to evaluate the relationship between dry eye (DE) and pain diagnoses in US veterans with and without traumatic brain injury (TBI).

Methods: Retrospective cohort study of veterans who were seen in the Veterans Administration Hospital (VA) between 1 January 2010 and 31 December 2014. Veterans were separated into two groups by the presence or absence of an International Classification of Diseases, Ninth Revision diagnosis of TBI and assessed for DE and other comorbidities.

Epidemiology of discordance between symptoms and signs of dry eye.

Background/aims: The frequent lack of association between dry eye (DE) symptoms and signs leads to challenges in diagnosing and assessing the disease.

Methods: Participants underwent ocular surface examinations to evaluate signs of disease and completed questionnaires to assess ocular symptoms, psychological status and medication use. To assess nociceptive system integrity, quantitative sensory testing (QST), including vibratory and thermal threshold measures and temporal summation of pain were obtained at the forearm and forehead.

Modified open-access scheduling for new patient evaluations at an academic chronic pain clinic increased patient access to care, but did not materially reduce their mean cancellation rate: A retrospective, observational study.

Study Objective: To determine if open-access scheduling would reduce the cancellation rate for new patient evaluations in a chronic pain clinic by at least 50%.

Design: Retrospective, observational study using electronic health records.

Setting: Chronic pain clinic of an academic anesthesia department.

The Association of Dry Eye Symptom Severity and Comorbid Insomnia in US Veterans.

Purpose: To investigate the association between dry eye (DE) and insomnia symptom severity.

Methods: Cross-sectional study of 187 individuals seen in the Miami Veterans Affairs eye clinic. An evaluation was performed consisting of questionnaires regarding insomnia (insomnia severity index [ISI]) and DE symptoms, including ocular pain, followed by a comprehensive ocular surface examination.

Bulbar conjunctival microvascular responses in dry eye.

Purpose: Conjunctival microvascular responses may be a surrogate metric of efferent neural pathway function innervating the ocular surface as changes in blood flow occur within seconds after a stimulus. As somatosensory dysfunction may partially underlie dry eye (DE), in this study we evaluate whether bulbar conjunctival microvascular alterations correlate with various aspects of DE.

Methods: Fifty-six DE patients were prospectively recruited from a Veterans Affairs ophthalmology clinic over an 11-month period.

Longitudinal Examination of Frequency of and Risk Factors for Severe Dry Eye Symptoms in US Veterans.

Importance: Dry eye syndrome is a common condition that affects millions of individuals. Many cross-sectional studies have evaluated risk factors for dry eye severity, but few have assessed risk factors or symptom progression over time.

Objectives: To assess symptom progression in dry eye syndrome and determine risk factors associated with severe symptoms at 1 year.

Assessment of Somatosensory Function in Patients With Idiopathic Dry Eye Symptoms.

Importance: Somatosensory dysfunction likely underlies dry eye (DE) symptoms in many individuals yet remains an understudied component of the disease. Its presence has important diagnostic and therapeutic implications.

Objective: To assess the integrity of nociceptive system processes in persons with DE and ocular pain using quantitative sensory testing (QST) techniques applied at a site remote from the eye.

Characteristics of Ocular Pain Complaints in Patients With Idiopathic Dry Eye Symptoms.

Objective: The purpose of this study was to examine the severity and quality of ocular pain complaints in patients with dry eye symptoms.

Methods: Subjects with clinically relevant dry eye symptoms (dryness, discomfort, tearing) of unknown origin seen in the Miami Veterans Affairs eye clinic were administered questionnaires for dry eye symptoms and ocular pain and underwent a standardized ocular examination. Qualities and severity ratings of ocular pain in subjects with idiopathic dry eye were compared with similar measures from published data in other chronic pain populations.

Corneal Mechanical Thresholds Negatively Associate With Dry Eye and Ocular Pain Symptoms.

Purpose: To examine associations between corneal mechanical thresholds and metrics of dry eye.

Methods: This was a cross-sectional study of individuals seen in the Miami Veterans Affairs eye clinic. The evaluation consisted of questionnaires regarding dry eye symptoms and ocular pain, corneal mechanical detection and pain thresholds, and a comprehensive ocular surface examination.

Burning Eye Syndrome: Do Neuropathic Pain Mechanisms Underlie Chronic Dry Eye?

Objective: Dry eye is a multi-factorial disorder that manifests with painful ocular symptoms and visual disturbances, which can only be partly attributed to tear dysfunction. This disorder may also involve neuroplasticity in response to neuronal injury. This review will emphasize the key characteristics of dry eye pain and its pathologic mechanisms, making the argument that a subset of dry eye represents a neuropathic pain disorder of the eye, more appropriately called "burning eye syndrome.