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Our Focus

Chronic Ocular Surface Pain

  • The cornea is one of the most densely innervated tissues in the body, making chronic ocular surface pain (COSP) a significant source of discomfort¹
  • COSP may be acute or chronic and can result from inflammation, infection, trauma, or nerve dysfunction, and is commonly described as burning, irritation, dryness, or grittiness²˒³
  • It frequently overlaps with dry eye disease (DED)²˒⁴˒⁵ and affects nearly 30% of the population, with women experiencing a higher prevalence and greater symptom severity²˒⁶
  • Despite its impact on quality of life, effective long-term treatments for COSP are limited, and current systemic or topical pain therapies are constrained by safety and efficacy concerns⁷–¹⁶
  • No FDA-approved treatments currently exist for COSP

Learn more about COSP

References 
  1. Müller LJ, Marfurt CF, Kruse F, Tervo TMT. Corneal nerves: Structure, contents and function. Exp Eye Res. 2003;76(5):521–542.
  2. Mehra D, Cohen NK, Galor A. Ocular surface pain: A narrative review. Ophthalmol Ther. 2020;9(3):1–21.
  3. Rosenthal P, Borsook D. Ocular neuropathic pain. Br J Ophthalmol. 2016;100(1):128–134.
  4. Galor A, Levitt RC, Felix ER, Sarantopoulos CD. Understanding the true burden of dry eye disease. Expert Rev Ophthalmol. 2015;10(5):403–405.
  5. Galor A, Covington D, Levitt AE, et al. Neuropathic ocular pain due to dry eye is associated with multiple comorbid chronic pain syndromes. J Pain. 2016;17(3):310–318.
  6. McDonald M, Patel DA, Keith MS, Snedecor SJ. Economic and humanistic burden of dry eye disease in Europe, North America, and Asia: A systematic literature review. Ocul Surf. 2016;14(2):144–167.
  7. Goyal S, Hamrah P. Understanding neuropathic corneal pain—Gaps and current therapeutic approaches. Semin Ophthalmol. 2016;31(1-2):59– 70.
  8. Iftinca M, Defaye M, Altier C. TRPV1-targeted drugs in development for human pain conditions. Drugs. 2021;81(1):7–27.
  9. Pereira VB, Garcia R, Torricelli AA, Bechara SJ. Opioids for ocular pain—A narrative review. Pain Physician. 2017;20(5):429–436.
  10. Brilakis HS, Deutsch TA. Topical tetracaine with bandage soft contact lens pain control after photorefractive keratectomy. J Refract Surg. 2000;16(4):444–447.
  11. Faktorovich EG, Melwani K. Efficacy and safety of pain relief medications after photorefractive keratectomy: Review of prospective randomized trials. J Cataract Refract Surg. 2014;40(10):1716– 1730.
  12. Kuhnle MD, Ryan DS, Coe CD, et al. Oral gabapentin for photorefractive keratectomy pain. J Cataract Refract Surg. 2011;37(2):364– 369.
  13. McGee HT, Fraunfelder FW. Toxicities of topical ophthalmic anesthetics. Expert Opin Drug Saf. 2007;6(6):637–640.
  14. Aragona P, Tripodi G, Spinella R, Lagan E, Ferreri G. The effects of the topical administration of non-steroidal anti-inflammatory drugs on corneal epithelium and corneal sensitivity in normal subjects. Eye (Lond.) 2000;14(2):206–210.
  15. Tomas-Barberan S, Fagerholm P. Influence of topical treatment on epithelial wound healing and pain in the early postoperative period following photorefractive keratectomy. Acta Ophthalmol Scand. 1999;77(2):135–138.
  16. Flach AJ. Corneal melts associated with topically applied nonsteroidal anti-inflammatory drugs. Trans Am Ophthalmol Soc. 2001;99:205–210.