Burning Eye Disorder: Does a Subset of Dry Eye Syndrome Represent a Neuropathic Pain Disorder?

Dry eye condition is an extremely common problem that is even now improperly comprehended, as there is often a disconnect between symptoms/pain and common clinical measures of dry eye. A recent review suggests burning eye syndrome (BES) as a unique sub-classification of chronic dry eye wherein pain and discomfort are brought on by pathology of the corneal somatosensory pathway in contrast to tear disfunction.
Persistent dry eye is called ocular pain and discomfort consisting of “dry skin,” “burning,” “itching,” and “foreign body sensation,” of differing duration and also seriousness. Dry eye is a typical as well as heterogenous condition, which impacts as many as 30% of people over the age of 50, lowering quality of life and also indirectly setting back society by an estimated $55.4 billion dollars annually.
Remember – In this literature review of chronic dry eye, the reviewers suggest burning eye syndrome as a subdivision of dry eye triggered by repeated ocular sensory nerve damage.
The reviewers seek to sum up the available literary works on chronic dry eye, highlighting the occurrence, pathological mechanisms as well as treatment alternatives.
” … Effective therapies are lacking as many treatment approaches generally focus on tear dysfunction as a line of treatment,” the reviewers state. “This also likely mirrors the discordance in between ocular pain and dry skin on the eye surface, where, in the reviewers’ opinion none exists. A different description is that pathology in the corneal somatosensory pathway might underlie eye pain in a subset of dry eye patients, and also this part may be better understood as a chronic neuropathic pain disorder, or ‘melting eye’.”
This evaluation was performed to summarize the literature on the connection between chronic dry eye and discomfort, as well as to figure out whether any kind of subclassification of dry eye is justified.
To assess the current knowledge of dry eye as a cause of ocular pain, the reviewers carried out a literature search back to 1970, looking for documents that explored the clinical course, pathophysiology, and neuronal regulation of chronic eye pain in individuals with dry eye. The reviewers also included one book in their testimonial.
In this testimonial, the reviewers highlight a subset of dry eye events in which the instance appears to be neuropathogenic and un-associated to tear film disorder per se. Termed burning eye disorder (BES), this condition is recommended here to be caused by a initial result (such as surgical procedure, trauma, or dry eye of a much more common etiology), which after that initiates an inflammatory cascade ending in hypersensitization of pain receptors in the eye. BES patients experience intense, stabbing pain spontaneously or because of otherwise innocuous insults consisting of wind, dirt bits, or bright light.
The author of the book draws resemblances between BES symptoms and those of patients struggling with chronic neuropathic pain disorders as proof on behalf of the BES hypothesis.
The reviewers highlight a variety of possible pathological mechanisms involving neuronal injury, hyperactivity, and also changes in the corneal microenvironment.
The presently available treatments offer some benefit in boosting tear function, nonetheless, “When central sensitization happens … BES pain might be spontaneous as well as unconnected to tear film dysfunction,” the reviewers describe. The neuropathological beginning of BES pain may additionally impede conventional analysis approaches, which usually measure patients’ tear duct function.
The reviewers as well as co-workers recommend that a focus on lowering surgical damage to eye nerves in addition to proper topical analgesic use may lower the significant number of patients with post-operative BES.
Further, the reviewers suggest that topical nonsteroidal anti-inflammatory drugs (NSAIDs) may give advantage in BES by decreasing inflammation, which is a key pathologic hallmark of the disorder.
“The absence of reliable treatment in cases of BES is a challenge that requires to be resolved by continued exploration, study and assessment of the detailed pathophysiology behind this condition (called BES) … ophthalmologists and also pain specialists think about dry eye as well as eye pain in various ways, as well as a combination of their expertise is required to establish more robust assessments of dry eye to strengthen any hypotheses and also further assess and also target the neuroplasticity of the corneal somatosensory pathway,” the reviewers end.
More directed research studies are required to determine whether the BES theory stands, and also to elucidate potential drug targets and therapeutic alternatives as well. Even a symptomatic therapy would certainly supply significant benefit in these patients, however, a pharmacological agent targeting the underlying disease mechanisms would certainly provide great hope to patients living in near-constant pain.

Leave a Reply

Your email address will not be published. Required fields are marked *