User:KhalidAlshehry/sandbox

Corneal neuropathic disease, corneal neuralgia, corneal neuropathy, or keratoneuralgia is a new and ill-defined disease entity in the field of ophthalmology.1 It has recently generated significant interest amongst both clinicians and scientists due to increasing awareness, and patients surfacing with unexplained ocular surface pain and symptoms.2,3 While the exact epidemiology of this disease remains to be elucidated, increased number of patients present with vague perceptions of burning, stinging, eye-ache, photophobia (photoallodynia)2,4 or severe eye-pain, without significant findings on slit-lamp examination. Currently, the field of Ophthalmology relies on slit-lamp examination to assess signs of corneal and ocular surface diseases. Unfortunately, with neuropathic pain, none to minimal signs can be observed on slit-lamp examination in patients who have been either given the rather broad diagnosis of dry eye disease, or have been repeatedly dismissed by their ophthalmologists. Nevertheless, scientists have in recent years made significant advances and elucidated 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, create confidence in identifying patients with neuropathic pain, and finally summarizing our experience with current therapeutic approaches for clinicians to better serve these unfortunate patients.

Signs and symptoms:

The patient with a corneal neuropathic disease would most often experience burning, foreign body sensation, photophobia in some people. The severity of the pain varies between the patients, but in most of them, it can affect the quality of their life.

Treatments and management:

There's no current cure for this disease. Many treatments were introduced by many doctors to manage this disease, including the use of artificial preservative free tears, Autologous serum eye drops, Autologous platelet rich plasma, as well as Steroid eye drops, to reduce the inflammation of the nerves. The main purpose of the Autologous serum, and the platelet-rich plasma is to increase the nerve density in the cornea to increase the corneal sensitivity. There is also Omega 3 fatty acid that shows very promoting outcomes when it comes to corneal neuropathy.

Causes:

refractive surgery (LASIK, PRK, FEMTO LASIK, LASEK, etc.), dry eye disease, Sjögren’s Syndrome, neuralgia associated with herpes virus, benzalkonium chloride (BAK) preserved eye drops, accutane, chemotherapy, and radiotherapy