Neuropathic Pain

Neuropathic mechanisms as the source of dry eye pain should be considered when dry eye symptoms persist despite appropriate treatment. In such cases central nervous system changes with pain attributed to centralized mechanisms should be targeted with such treatment as Gabapentin and/or Effexor or Cymbalta, other. Patients with a neuropathic component to their eye discomfort can also benefit from amniotic membranes, autologous serum, platelet rich plasma (PRP) and scleral contact lenses.

The incidence of neuropathic pain has been noted to be higher in patients with a history of migraines and/or fibromyalgia.

Neuropathic ocular pain: an important yet underevaluated feature of dry eye

Vitamin B12 deficiency evaluation and treatment in severe dry eye disease with neuropathic ocular pain