Indicators include persistent high corneal tactile sensitivity postanesthesia, reduced nerve density, increased microneuroma density in central cornea
By Elana Gotkine HealthDay Reporter
TUESDAY, July 22, 2025 (HealthDay News) — In a study published in the August issue of the American Journal of Ophthalmology, diagnostic indicators are identified for confirming chronic neuropathic ocular pain (NOP) for patients experiencing chronic dry eye (DE) after laser-assisted in situ keratomileusis (LASIK).
In a prospective cross-sectional comparison study, Amanda Vázquez, Ph.D., from the Institute of Applied Ophthalmobiology at the Universidad de Valladolid in Spain, and colleagues compared the clinical characteristics of patients who developed both DE and NOP after LASIK to those with only DE and to asymptomatic LASIK patients. The study included 89 patients: 34 developed NOP and DE, 25 developed only DE, and 30 were asymptomatic controls.
The researchers found that patients in the NOP-DE group exhibited significantly more DE symptoms with the Modified Single-Item Dry Eye Questionnaire, a higher level of pain with the Numerical Rating Scale and Wong-Baker Faces Pain Rating Scale, increased use of ocular lubrication, greater frequency of pathological results on anxiety and depression questionnaires, and a higher prevalence of central sensitization syndromes compared with the DE group. Higher tactile corneal sensitivity was also demonstrated by NOP-DE patients after topical anesthesia. Compared with DE patients without NOP, DE-NOP patients had lower nerve density on in vivo confocal microscopy and higher microneuroma density in the sub-basal nerve plexus. Moderate-to-strong correlations were seen for most nerve metrics with clinical parameters.
“Our study revealed that higher post-topical anesthesia corneal tactile sensitivity, lower nerve density and higher microneuromas density in the sub-basal corneal nerve plexus are signs that can help diagnose NOP in patients suffering from DE and pain after refractive surgery,” the authors write.
Two authors disclosed ties to the biopharmaceutical industry.
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