Chronic Ocular Surface Pain: An Optometrist and Ophthalmologist Survey.

Introduction: Chronic ocular surface pain (COSP) is defined as ocular pain that is perceived to originate from the ocular surface and persists for more than 3 months. Clear epidemiological data on COSP prevalence are lacking.

Methods: In 2025, a total of 100 eye care providers were surveyed, including 50 optometrists and 50 ophthalmologists.

Differences in pre-surgical baseline tear proteome are associated with persistent post-refractive surgery pain.

Purpose: Most patients who undergo refractive surgery have excellent outcomes, but a subset experience persistent eye pain after the procedure. We hypothesized that pre-operative tear fluid proteins are distinct in patients who develop pain after surgery.

Methods: Patients undergoing refractive surgery (LASIK or PRK) provided tear fluid samples and eye pain reports (numeric rating scale (NRS) 0-10) before (baseline) and after surgery.

Where eye meets body part 1: uniting allergy pathways in ocular and nasal disease - IgE on the offense.

Purpose Of Review: This review explores the shared immunologic mechanisms and clinical distinctions between seasonal and perennial allergic rhinitis (SAR, PAR) and their ocular counterparts, seasonal and perennial allergic conjunctivitis (SAC, PAC). These IgE-mediated diseases often coexist, reflecting overlapping triggers, mast cell activation, and mucosal immune responses. By comparing their epidemiology, pathophysiology, genetics, and treatments, this review highlights how nasal and ocular allergic pathways intersect and diverge.

Where eye meets body part 2: uniting allergy pathways in ocular and atopic disease - T cells take the lead.

Purpose Of Review: This review compares the T-cell-mediated pathways of atopic dermatitis and atopic keratoconjunctivitis (AKC), as well as allergic asthma and vernal conjunctivitis (VKC).These chronic, T cell-mediated conditions frequently coexist and are unified by Th2-driven inflammation, epithelial barrier dysfunction, and tissue remodeling. By comparing their epidemiology, pathogenesis, genetic contributors, and therapeutic approaches, this review examines how skin, airway, and ocular allergic pathways intersect and diverge.

Navigating the Dry Eye Therapeutic Puzzle: A Mechanism-Based Overview of Current Treatments.

: Dry eye disease (DED) is a multifactorial condition with complex pathophysiology involving tear film instability, ocular surface inflammation, and nerve dysfunction. This review summarizes current evidence on the different available therapies targeting these mechanisms. : A review of clinical studies evaluating treatment outcomes for therapies targeting aqueous tear deficiency, Meibomian gland dysfunction, ocular surface inflammation, and ocular pain was conducted, with an emphasis on randomized controlled trials and meta-analyses where available.

Corneal sensory nerve regulation of tear production through stimulation of transient receptor potential melastatin 8 (TRPM8) channel: A potential new approach for treating dry eye disease.

The lacrimal functional unit (LFU) tightly controls the secretion of all tear components, thus playing a critical role in maintaining ocular surface homeostasis. Forming an exquisitely sensitive neural network across the ocular surface, corneal sensory nerves detect environmental stimuli (e.g.

Specific clinical phenotypes of dry eye disease can predict the presence of matrix metalloproteinase-9 in the ocular surface.

Objective: The InflammaDry test detects matrix metalloproteinase-9 (MMP-9) in tears, a biomarker associated with ocular surface inflammation. While a positive result may indicate the need for anti-inflammatory therapy, its cost and qualitative nature limit widespread use. This study aims to identify clinical phenotypes that predict positive InflammaDry results, facilitating targeted anti-inflammatory therapy without requiring MMP-9 testing.

Serological Influences on Dry Eye: Insights from the Sjögren's International Collaborative Clinical Alliance.

Purpose: To define associations between serologies, specifically Sjögren syndrome-related antigen A (SSA) antibody and immunoglobulin (Ig) levels, on ocular profiles in patients enrolled in the Sjögren's International Collaborative Clinical Alliance (SICCA) cohort.

Design: A retrospective cohort study.

Subjects: Individuals from the SICCA cohort (n = 3514).

Microstructural alterations of the trigeminal ganglion in chronic ocular surface pain patients: A diffusion MRI study.

Noxious stimuli to the ocular surface are encoded by sensory axons of trigeminal ganglion (TG) neurons and conveyed through the ophthalmic branch of the trigeminal nerve (CN V1). We hypothesized that chronic ocular surface pain (COSP) may be associated with microstructural alterations of the trigeminal nerve structures. Our objective was to demonstrate the feasibility of using diffusion tractography to identify and analyze diffusion properties to assess TG microstructure in individuals with and without COSP.

Subepithelial Lesions of the Ocular Surface: A Review.

Purpose Of Review: Subepithelial lesions of the ocular surface represent a diverse group of pathologies which may be difficult to diagnose clinically. Some of these lesions are relatively uncommon, may result in systemic manifestations, or occur secondary to systemic disease. The purpose of this review is to summarize current approaches to the diagnosis and management of six subepithelial conjunctival lesions.

Heightened visual light sensitivity discomfort measured by the ocular photosensitivity analyzer is associated with chronic ocular pain.

Purpose: To quantify visual photosensitivity discomfort thresholds (VPDT) in individuals with chronic ocular pain (COP) compared to controls without COP and explore relationships between VPDT, demographics, clinical factors, and ocular metrics.

Methods: Prospective case-control study of 75 participants: 36 with COP (age 46.5 ± 15.

All eyes on semifluorinated alkanes: a comprehensive review of the influence of semifluorinated alkane eyedrops on tear film stabilization and drug delivery in dry eye disease.

Introduction: Dry eye disease (DED) is a prevalent and multifactorial ocular disorder characterized by tear film instability, ocular surface inflammation, and patient discomfort, negatively impacting the quality of life. Conventional therapies have limitations due to poor drug bioavailability and patient tolerability.

Areas Covered: This review summarizes the application of semifluorinated alkanes (SFAs) as advanced ocular drug delivery systems, with a focus on perfluorobutylpentane (PFBP)-based cyclosporine A (CsA) eyedrops.

Emerging Techniques in the Treatment of Conjunctival Melanoma.

Purpose Of Review: In this article, we summarize the pathogenesis, diagnostic challenges, current management, and emerging therapeutic strategies for conjunctival melanoma (CM).

Recent Findings: CM is a deadly disease with rising global incidence. Key mutations, including BRAF, NF1, and TERT, play crucial roles in CM pathogenesis and may serve as targets for therapy.

Assessing Tear Secretory Response in Health and Disease Using a Novel i-Onion Device.

Purpose: To evaluate tear secretory response using a novel device, the i-Onion, which stimulates lacrimal gland activity with concentrated CO 2 bursts.

Methods: The i-Onion device delivers a controlled CO 2 burst to the ocular surface, stimulating the lacrimal gland's tear production response. We studied 120 participants: 40 with glaucoma, 40 with cataracts (some followed postsurgery), and 40 controls.

TFOS DEWS III Digest Report.

This digest summarises the interdisciplinary research in dry eye disease (DED) published since the 2017 TFOS DEWS II reports. It comprises seven topics including Sex, Gender, and Hormones, Epidemiology, Pathophysiology, Tear Film, Pain and Sensation, Iatrogenic and Clinical Trial Design and explores how each of these inform diagnostic methodology, disease subtype and management of DED. Sex- and gender-related differences significantly influence the ocular surface due to hormones, sex chromosomes, sex-specific autosomal factors, epigenetics, care-seeking behaviors, and service utilization.

The Impact of Home Interventions on Dry Eye Disease (DED) Symptoms and Signs in United States Veterans.

Background: The indoor environment can contribute to dry eye disease (DED) risk, but the effects of environmental modifications on disease are still uncertain. This study evaluated the effect of home interventions that modify the indoor environment on DED symptoms and sign severity.

Methods: The prospective study consisted of two visits (6 ± 1 months apart).

The eye as a window to oral and pain symptoms in Sjögren's disease.

Background: To investigate whether certain dry eye (DE) metrics relate to oral and pain manifestations of Sjögren's disease (SjD).

Methods: Secondary analysis of the Sjögren's International Collaborative Clinical Alliance dataset containing 1541 individuals with 2016 American College of Rheumatology/European League Against Rheumatism defined SjD. Binary logistic regression analyses examined which of 13 DE features related to various extraocular metrics.

Genome-wide association study of dry eye disease reveals shared heritability with systemic comorbidities.

Dry eye disease (DED) affects up to 25% of the adult population, with chronic symptoms of pain and dryness often negatively impacting quality of life. The genetic architecture of DED is largely unknown. Here, we develop and validate an algorithm for DED in the Million Veteran Program using a combination of diagnosis codes and prescription records, resulting in 132,657 cases and 352,201 controls.

Influence of Adipose Tissue on Ocular Inflammation.

Purpose: We present a case of ocular pathology linked to morbid obesity, emphasizing the role of systemic inflammation in ocular disease and clinical impact of weight loss.

Methods: We report the case of a 49-year-old man with morbid obesity and obstructive sleep apnea who underwent bilateral corneal transplants secondary to keratoconus. For 4 years, he had chronic bulbar hyperemia with progressive blood vessel growth across the graft-host junction, which was treated with chronic topical corticosteroids.

Cornea specialists are the highest opioid prescribers at a large academic eye institute in the USA.

Background/aim: To evaluate the opioid prescription patterns across ophthalmic subspecialties at a large academic eye centre.

Methods: A single site, retrospective cross-sectional study. Electronic medical records from the year 2018 were screened.

Detection of Ocular Surface Squamous Neoplasia Using Artificial Intelligence With Anterior Segment Optical Coherence Tomography.

Purpose: To develop and validate a deep learning (DL) model to differentiate ocular surface squamous neoplasia (OSSN) from pterygium and pinguecula using high-resolution anterior segment optical coherence tomography (AS-OCT).

Design: Retrospective Diagnostic Accuracy Study.

Methods: Setting: Single-center.

Impact of botulinum toxin type A on ocular pain with neuropathic features.

Purpose: To investigate the impact of botulinum toxin type A (BoNT-A) on neuropathic/nociplastic ocular pain (NOP) and identify predictors of patient outcomes.

Methods: A retrospective study of individuals with NOP symptoms (light sensitivity, wind/air sensitivity, persistent pain despite dry eye treatment) who received ≥1 BoNT-A injection. Primary outcome measures included if (responders vs.

Immune Checkpoint Inhibitors in the Treatment of Ocular Surface Cancers: A Review.

Background: Immune checkpoint inhibitors (ICIs) have transformed cancer therapy by targeting key immune pathways such as PD-1, PD-L1, CTLA-4, and LAG-3 to enhance the immune system's ability to combat malignancies. Their use in treating ocular surface tumors is an emerging area of interest, particularly in conjunctival melanoma (CM) and ocular surface squamous neoplasia (OSSN). Some studies have indicated the potential of ICI's in sebaceous gland carcinoma (SeC), conjunctival lymphoma, and Kaposi sarcoma.

CORONIS symposium 2023: Scientific and clinical frontiers in ocular surface innervation.

The 5th CORONIS Symposium, held during the 2023 Congress of the European Association for Vision and Eye Research (EVER), highlighted the growing importance of ocular surface innervation in eye surface disorders. This article summarises the insights and perspectives shared during the symposium, which focused on the clinical relevance of ocular surface innervation, as well as on the development of innovative diagnostic and therapeutic approaches for ocular surface pathologies linked to disturbed sensory innervation. Through robust interdisciplinary collaborations, these developments hold great potential to improve patient outcomes and quality of life.