title: Understanding Neuropathic Corneal Pain--Gaps and Current Therapeutic Approaches.
abstract: The richly innervated corneal tissue is one of the most powerful pain generators in the body. Corneal neuropathic pain results from dysfunctional nerves causing perceptions such as burning, stinging, eye-ache, and pain. Various inflammatory diseases, neurological diseases, and surgical interventions can be the underlying cause of corneal neuropathic pain. Recent efforts have been made by the scientific community to elucidate the pathophysiology and neurobiology of pain resulting from initially protective physiological reflexes, to a more persistent chronic state. The goal of this clinical review is to briefly summarize the pathophysiology of neuropathic corneal pain, describe how to systematically approach the diagnosis of these patients, and finally summarizing our experience with current therapeutic approaches for the treatment of corneal neuropathic pain.
authors.affiliation: a Cornea & Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School , Boston , Massachusetts , USA .
authors.forename: Sunali
authors.initials: S
authors.lastname: Goyal
authors.affiliation: a Cornea & Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School , Boston , Massachusetts , USA .|b Ocular Surface Imaging Center, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School , Boston , Massachusetts , USA .|c Boston Image Reading Center & Cornea Service, New England Eye Center , Boston , Massachusetts , USA , and.|d Department of Ophthalmology , Tufts Medical Center, Tufts University School of Medicine , Boston , Massachusetts , USA.
authors.forename: Pedram
authors.initials: P
authors.lastname: Hamrah
mesh_terms: D003315:Cornea / Q000294:innervation*; D016207:Cytokines / Q000627:therapeutic use; D058447:Eye Pain / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000627:therapeutic use; D009437:Neuralgia / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D009882:Ophthalmic Nerve / Q000503:physiopathology*
chemical_list: D016207:Cytokines; D036341:Intercellular Signaling Peptides and Proteins
keywords: Autologous serum drops; corneal neural anatomy; corneal pain; dry eye; in vivo confocal microscopy; neuropathic pain