What Are the Causes of Eye Pain?

There are many causes of Eye Pain. The most common cause is dry eye and/or meibomian gland dysfunction/atrophy or clogging. Anyone who has had a stye knows how debilitating it can be to have a clogged gland. Recently I had a surgeon in my chair crying because of a stye. It was not infected but it was so painful, this surgeon could not stop crying over the sleepless nights and pain it was causing. There are other causes of Pain without Stain or  Neuropathic Eye Pain (also called Corneal Neuropathy, or Neuropathic Corneal Pain)
Below is a modified list. It originates from Dr. Hamrah’s excellent review on the topic referenced below with some added notes I have seen.
Ocular Diseases
Dry eye disease4–6,12
Meibomian Gland Disease/Atrophy
Infectious keratitis13
Herpetic keratitis23,38
Recurrent erosion syndrome13
Radiation keratopathy13
Refractive surgery: LASIK, PRK, PTK, RK6,9
Cataract surgery5
Post Corneal Transplant
Systemic diseases
Small-fiber polyneuropathy4,6
Trigeminal neuralgia5
Medication-induced neuropathy (chemotherapy)
Post Radiation treatment near eyes
Autoimmune conditions (Sjögren’s syndome, Lupus, Rheumatoid Arthritis, Sarcoidosis, inflammatory bowel disease, Celiac disease)4
Oculofacial pain5
Posttraumatic stress disorders12
 2017 Nov;124(11S):S34-S47. doi: 10.1016/j.ophtha.2017.08.004.

Neuropathic Corneal Pain: Approaches for Management.


Neuropathic pain is caused by a primary lesion or dysfunction of the nervous system and can occur in the cornea. However, neuropathic corneal pain (NCP) is currently an ill-defined disease. Patients with NCP are extremely challenging to manage, and evidence-based clinical recommendations for the management of patients with NCP are scarce. The objectives of this review are to provide guidelines for diagnosis and treatment of patients with NCP and to summarize current evidence-based literature in this area. We performed a systematic literature search of all relevant publications between 1966 and 2017. Treatment recommendations are, in part, based on methodologically sound randomized controlled trials (RCTs), demonstrating superiority to placebo or relevant control treatments, and on the consistency of evidence, degree of efficacy, and safety. In addition, the recommendations include our own extensive experience in the management of these patients over the past decade. A comprehensive algorithm, based on clinical evaluation and complementary tests, is presented for diagnosis and subcategorization of patients with NCP. Recommended first-line topical treatments include neuroregenerative and anti-inflammatory agents, and first-line systemic pharmacotherapy includes tricyclic antidepressants and an anticonvulsant. Second-line oral treatments recommended include an opioid-antagonist and opiate analgesics. Complementary and alternative treatments, such as cardiovascular exercise, acupuncture, omega-3 fatty acid supplementation, and gluten-free diet, may have additional benefits, as do potential noninvasive and invasive procedures in recalcitrant cases. Medication selection should be tailored on an individual basis, considering side effects, comorbidities, and levels of peripheral and centralized pain. Nevertheless, there is an urgent need for long-term studies and RCTs assessing the efficacy of treatments for NCP.
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