Ocular Surface Pain: A Narrative Review

Ocular surface pain is a frequent cause of visits to an eye care providerand has a substantial impact on healthcare cost, yet a complete understanding of itscausative factors and tools for diagnostic workup are notably missing in many eyeclinics. The cornea has the densest sensory innervation in the human body and has thepotential to be a powerful producer of pain. Pain can manifest as a result of a noxiousstimulus or disruption in the ocular surface anatomy (nociceptive pain), or it canresult from abnormalities in the ocular surface neurosensory apparatus itself(neuropathic pain). Novel advances in neurobiology have sought to differentiate the twoentities, particularly to identify when chronic dry eye symptomatology is driven byneuropathic ocular pain. In this review, we seek to provide an overview of theprevalence, physiologic factors, and management of ocular surface paincomplaints.