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Eye (London, England) Apr 2018PurposeFibromyalgia (FM) is a chronic pain disorder associated with pain and hypersensitivity in various parts of the body. The aim of this study was to understand...
PurposeFibromyalgia (FM) is a chronic pain disorder associated with pain and hypersensitivity in various parts of the body. The aim of this study was to understand whether changes in corneal sensitivity were associated with the subjective complaints of these patients.Patients and methodsIn this study, we included 36 patients with FM (30 female, 6 male, mean age: 46.7±9.2 years) and 39 healthy control subjects (33 females, 6 males, mean age: 44.3±7.6 years). We performed a detailed ophthalmological examination, measured tear film breakup time (TBUT), and performed Schirmer I test without anesthetic (SIT). Only patients that did not have any eye disease were included in this study. Subjective complaints of the patients were evaluated with ocular surface disease index (OSDI) scores and the corneal sensation was evaluated with Cochet-Bonnet esthesiometer.ResultsThere was no significant difference between the groups for age, sex, and visual acuity. Both SIT (16.1 mm vs 15.3 mm, P=0.36) and TBUT results (17.8 s vs 18.8 s, P=0.40) were similar in FM group and the controls subjects. However, corneal sensations in central (60.0 mm vs 55.0 mm, P=0.03), superior (57.5 mm vs 50.0 mm, P=0.005), and inferior (53.89 mm vs 46.03 mm, P<0.001) regions were significantly increased in FM patients. There was a significant positive correlation between corneal sensation and OSDI scores.ConclusionIn this study, we have demonstrated that the patients with FM have increased corneal sensitivity and have related ocular surface complaints similar to dry eye disease in the absence of it.
Topics: Adult; Case-Control Studies; Cornea; Dry Eye Syndromes; Eye Pain; Female; Fibromyalgia; Humans; Male; Middle Aged; Tears; Visual Acuity
PubMed: 29386615
DOI: 10.1038/eye.2017.275 -
Arquivos Brasileiros de Oftalmologia 2016
Topics: Chronic Pain; Cornea; Corneal Diseases; Eye Pain; Humans; Neuralgia; Trigeminal Ganglion
PubMed: 27463638
DOI: 10.5935/0004-2749.20160042 -
Indian Journal of Ophthalmology Jul 2020Ocular pain is a common complaint which forces the patient to seek immediate medical attention. It is the primeval first response of the body to any severe condition of... (Review)
Review
Ocular pain is a common complaint which forces the patient to seek immediate medical attention. It is the primeval first response of the body to any severe condition of the eye such as trauma, infections and inflammation. The pain can be due to conditions directly affecting the eye and ocular adnexa; or indirect which would manifest as referred pain from other organ structures such as the central nervous system. Paradoxically, there are several minor and non-sight threatening conditions, which also leads to ocular pain and does not merit urgent hospital visits. In this perspective, we intend to provide guidelines to the practising ophthalmologist for teleconsultation when a patient complains of pain with focus on how to differentiate the various diagnoses that can be managed over teleconsultation and those requiring emergency care in the clinic. These guidelines can decrease unnecessary hospital visits, which is the need of the hour in the pandemic era and also beyond. Patients who are under quarantine and those who are unable to travel would be benefitted, and at the same time, the burden of increased patient load in busy hospital systems can be reduced.
Topics: Acute Pain; Betacoronavirus; COVID-19; Coronavirus Infections; Diagnosis, Differential; Disease Transmission, Infectious; Eye Pain; Humans; Pandemics; Pneumonia, Viral; SARS-CoV-2; Telemedicine
PubMed: 32587167
DOI: 10.4103/ijo.IJO_1267_20 -
Drugs Apr 2020Despite being a common presenting symptom to eye-care clinics, many ophthalmologists have difficulty diagnosing and managing ocular surface pain. The purpose of this... (Review)
Review
Despite being a common presenting symptom to eye-care clinics, many ophthalmologists have difficulty diagnosing and managing ocular surface pain. The purpose of this review is to discuss potential causes of ocular surface pain, focusing on both nociceptive and neuropathic aetiologies. Specifically, we outline an approach to the diagnosis of ocular surface pain and focus on various management strategies, providing supporting evidence on the efficacy of various treatments.
Topics: Eye Pain; Humans; Neuralgia; Pain Management
PubMed: 32207101
DOI: 10.1007/s40265-020-01282-3 -
Klinische Monatsblatter Fur... Nov 2014Optic neuritis is a frequent neuro-ophthalmological disease in which the diagnosis can be based on just a few symptoms and findings. It is not only important to... (Review)
Review
Optic neuritis is a frequent neuro-ophthalmological disease in which the diagnosis can be based on just a few symptoms and findings. It is not only important to differentiate from other optic nerve disorders but also to recognise special types of optic neuritis, which is mostly only possible during the course of the disease. This article presents a review of the current state in diagnosis and therapy from the authors' personal point of view.
Topics: Anti-Inflammatory Agents; Diagnosis, Differential; Eye Pain; Humans; Multiple Sclerosis; Optic Neuritis; Vision Disorders
PubMed: 25285570
DOI: 10.1055/s-0034-1382930 -
Ocular Immunology and Inflammation Apr 2021: To identify alterations in neuropathic and inflammatory pain gene expression associated with contact lens (CL) wear and CL discomfort (CLD).: Eight non-wearers, eight...
: To identify alterations in neuropathic and inflammatory pain gene expression associated with contact lens (CL) wear and CL discomfort (CLD).: Eight non-wearers, eight asymptomatic CL wearers (CLWs) and eight symptomatic CLWs were included. Conjunctival cells were collected by impression cytology and the mRNA expression levels of 85 genes were analyzed. Differentially expressed genes between non-wearers and CLWs and between asymptomatic and symptomatic CLWs were analyzed. An enrichment analysis was also performed.: Twelve genes were upregulated (including , and ) and 28 downregulated (, , , and ) in CLWs (p ≤ 0.050). Eleven genes were upregulated (, , , and ) and nine downregulated ( and ) in symptomatic CLWs (p ≤ 0.035). Enriched overrepresented terms were related to pain, neuronal transmission and inflammation.: Contact lens wear might produce a desensitization-like mechanism responsible for comfortable CL wear. A malfunction of this mechanism might contribute to CLD.
Topics: Adult; Conjunctival Diseases; Contact Lenses, Hydrophilic; Eye Pain; Eye Proteins; Female; Gene Expression Regulation; Humans; Inflammation; Male; Neuralgia; Pain Measurement; Prosthesis Fitting; RNA, Messenger; Young Adult
PubMed: 31825696
DOI: 10.1080/09273948.2019.1690005 -
Investigative Ophthalmology & Visual... Mar 2021The purpose of this study was to test the role of substance P (SP) and its receptor neurokinin 1 (NK1R) on ocular surface pain.
PURPOSE
The purpose of this study was to test the role of substance P (SP) and its receptor neurokinin 1 (NK1R) on ocular surface pain.
METHODS
Eight-week-old C57BL6/N (wild type [WT]) and B6.Cg-Tac1tm1Bbm/J (TAC1-KO) male mice were used. 5 M NaCl was topically applied on the cornea, followed by topical fosaprepitant 2, 10, and 50 mg/mL; 4 mg/mL oxybuprocaine chloride, or 0.1% diclofenac. Th eye wiping test was used to quantify ocular surface pain. SP content was quantified in the tear fluid and trigeminal ganglia (TG), and TAC1 mRNA was assessed in the cornea. Corneas were immunostained for β3-tubulin and NK1R, or CD45, to quantify leukocyte infiltration.
RESULTS
TAC1-KO mice displayed a significant reduction of ocular pain (P < 0.001). Similarly, a single dose of 10 or 50 mg/mL fosaprepitant applied topically to WT mice reduced ocular pain as compared to vehicle (P < 0.001). Fosaprepitant 2 mg/mL, instead, induced corneal analgesia only when it was administered for 10 days, 6 times/day (P < 0.05). Diclofenac or oxybuprocaine reduced corneal nociception when compared to vehicle or fosaprepitant (P < 0.05). Fosaprepitant or oxybuprocaine groups showed lower SP content in tear secretions and TG (P < 0.05), and reduction in TAC1 mRNA (P < 0.05), and leukocyte infiltration (P < 0.05) in the cornea. Colocalization of NK1R and β3-tubulin was detected in mouse corneas.
CONCLUSIONS
Topical administration of the NK1R antagonist fosaprepitant effectively reduces ocular surface nociception by decreasing SP release in the tear fluid and TG, and corneal leukocyte infiltration. Fosaprepitant repurposing shows promise for the treatment of ocular pain.
Topics: Administration, Ophthalmic; Animals; Cornea; Corneal Diseases; Disease Models, Animal; Eye Pain; Male; Mice; Mice, Inbred C57BL; Mice, Knockout; Morpholines; Neurokinin-1 Receptor Antagonists; Nociception; Ophthalmic Solutions; Substance P; Tears; Trigeminal Nerve
PubMed: 33729475
DOI: 10.1167/iovs.62.3.26 -
Retina (Philadelphia, Pa.) Jan 2015
Topics: Anti-Inflammatory Agents, Non-Steroidal; Benzeneacetamides; Eye Pain; Female; Humans; Intravitreal Injections; Male; Phenylacetates
PubMed: 25473790
DOI: 10.1097/IAE.0000000000000424 -
Cornea Nov 2019Patients with corneal and conjunctival disorders report an array of ocular surface symptoms including stinging, foreign body sensation, and itching. The intensity and... (Review)
Review
Patients with corneal and conjunctival disorders report an array of ocular surface symptoms including stinging, foreign body sensation, and itching. The intensity and perceptual quality of these sensations and their duration, from brief intervals to long-term symptoms, also vary. We hypothesize that symptomatic differences across disorders reflect differences in the balance between ocular inflammation and nerve injury, with different conditions resulting from predominant effects of one of these, or a combined effect. This article provides an overview of corneal and conjunctival nerve cells, such as nociceptors and thermoreceptors, with descriptions of their morphological and molecular characteristics and their nerve-firing patterns and evoked sensations, as determined by earlier studies in animals and humans. Detailed descriptions of the changes in neuronal responses (such as abnormal responsiveness and spontaneous firing) due to local inflammation and nerve injury are provided, and assorted ocular surface disorders are discussed. Eye conditions in which inflammation is predominant include allergic conjunctivitis and photokeratitis, whereas nerve injury is the primary factor underlying complaints of dry eye after photorefractive keratectomy and in elderly patients. Both factors contribute substantially to dry eye disease and varicella-zoster infections. This model of the combined effects of inflammation and nerve injury serves to explain the different sensations reported in various eye surface disorders, including short-term versus chronic pain and dysesthesias, and may help to improve diagnoses and treatment methods.
Topics: Cornea; Dry Eye Syndromes; Eye Pain; Humans; Keratitis; Nociceptors; Sensation; Tears; Thermoreceptors
PubMed: 31490785
DOI: 10.1097/ICO.0000000000002116 -
Ophthalmology Dec 2015
Topics: Brachytherapy; Ciliary Body; Eye Enucleation; Eye Pain; Female; Humans; Macrophages; Melanoma; Melanosomes; Middle Aged; Ocular Hypertension; Trabecular Meshwork; Uveal Neoplasms
PubMed: 26592671
DOI: 10.1016/j.ophtha.2015.09.006