A disorder known as neuropathic corneal pain causes your eyes, face, or head to become overly sensitive. It also causes them pain. Corneal neuralgia is another name for this illness. The specific etiology is unknown. They believe it is caused by corneal nerve injury mixed with inflammation. Your nervous system will not function properly as a result of this combination.
Dry eye illness is a common misdiagnosis for this ailment. It can cause severe and debilitating pain if left untreated.
What Is Somatic Symptom Disorder and How Does It Affect You?
Somatic symptom disorder is characterized by excessive distress caused by pain and other physical ailments. Somatic symptom disorder can lead to suicide in rare circumstances. If you have a somatic symptom disorder, neuropathic corneal pain might exacerbate your symptoms.
The sooner you get diagnosed and treated, the better.
Symptoms
The following are symptoms of neuropathic corneal discomfort that affect the eyes:
- sensitivity to air and light
- pain
- burning sensation
- dryness in the eyes
- foreign body sensation in the eyes
The signs and symptoms are not necessarily limited to the eyes. The cornea and the surrounding areas share a nerve supply. This disorder can cause pain or ache in the face, ears, or head in certain patients.
The symptoms of neuropathic corneal discomfort and dry eye illness can sometimes be confused. However, patients with neuropathic corneal pain may not show signs of dryness during an eye exam. Conventional dry eye treatments frequently do not help those with neuropathic corneal pain.
Causes
Neuropathic corneal pain can be caused by any disorder that damages the corneal nerve.
A tiny percentage of patients will develop the illness as a result of:
- Cataract surgery
- LASIK
- Other eye surgeries
Neuropathic corneal pain can be caused by a variety of factors, including:
- diabetes
- radiation therapy
- toxicity from preservatives
- chronic dry eye disease
- extended contact lens wear
- Trigeminal neuralgia, a chronic pain disorder that affects the face
- any ailment that might cause nerve injury on a systemic level
Nerves that have been damaged normally heal on their own. Untreated inflammation, on the other hand, might make injured nerves even more sensitive. The damage and inflammation must be addressed by you and your ophthalmologist. If not, they may cause incorrect signals to be delivered to and from the brain over time. The resulting pain or distress is similar to the phantom pain that amputees endure.
Neuropathic corneal pain appears to be more common in people who already have neurological or psychological issues. These are some of the conditions:
- anxiety
- depression
- migraines that last a long time
- headaches
- fibromyalgia
- autoimmune illness
This link needs to be confirmed by more research.
Diagnosis
When dry eye therapies and pain drops do not help, doctors suspect neuropathic corneal discomfort. To diagnose it, they employ a high-powered microscope to do confocal microscopy. An ophthalmologist or neurologist can use this microscope to look for nerve problems. Many practices do not have these specialized microscopes. Some academic institutions and large multi-specialty private practices have the technology. You may have to travel to acquire this test.
Many people who suffer from neuropathic corneal discomfort are told that their sensations are all in their thoughts. According to Pedram Hamrah, an ophthalmologist and corneal specialist at Tufts Medical Center, it is vital that these folks do not give up and seek another opinion.
Treatment
The goal of treatment for neuropathic corneal pain has two goals:
- nerve regeneration
- to lessen nerve sensitivity by reducing inflammation
The following are some examples of treatments:
- Using the patient’s own blood, ocular drops are created (autologous serum tears)
- Anti-inflammatory steroids at low doses
- Lenses made of amniotic membrane
- Neurostimulation
- Glasses with a blue filter
- Therapies that target the nervous system as a whole are known as systemic neuromodulatory therapies
- Topical recombinant corneal nerve growth factor
Other therapies are in the works.
According to Dr. Hamrah, the shorter the time between diagnosis and therapy, the more likely a patient will get total relief from neuropathic corneal pain.
