Most people take their eyes for granted and give them little thought throughout their day. But for some, eye pain can be completely debilitating and has a massive negative impact on their quality of life.
This article looks at what causes this pain and how your eye care practitioner may grade your pain in order to baseline it prior to treatment. This allows you to monitor your progress as the underlying cause of your eye pain is diagnosed and treated.
Causes of ocular pain
Eye pain can have many causes. Trauma (such as from injury, surgery or acute eye disease) can cause intense but short-lived pain. Longer-lasting and more debilitating pain can have many causes including severe corneal disease and ocular inflammation (such as iritis). But the most common cause of prolonged, debilitating eye pain is severe dry eye disease.
Types of eye pain
Many of the early symptoms of dry eye disease, such as burning, dryness and foreign body sensation are not described as ‘pain’. More severe dry eye disease, however, can be associated with the sensation of neuropathic pain, which can be limiting enough to prevent you from doing things you enjoy. We see people regularly who tell us they can no longer watch TV, wear make up or use a computer due to pain, and this has led to loss of jobs, relationships and enjoyment of life.
Why do eyes hurt so much?
Studies have shown that eye pain is often experienced as worse than pain from any other part of your body. Your cornea – the front surface of your eye – has 300-600 more nerve endings than skin and 20-40 times more than tooth pulp, making it the most sensitive organ in the body.
In normal eyes, these nerves in your cornea monitor your tear film, to make sure it’s doing a good job. If they pick up that the tear film is too thin, they will trigger your lacrimal tear gland to produce more watery tears and fix the problem. But, if your tear film is poor for a long period of time, the nerve endings in the cornea can become damaged. This can lead to pain persisting for months or years after the initial damage, even if the damage appears to have been repaired.
What is neuropathic pain?
This type of pain occurs in and around the eye when the nerve endings of the cornea are damaged. The damage may be from surgery, trauma as well as severe dry eye disease.
When the nerves are damaged, the corneal tissue becomes so sensitive that normal sensations that don’t usually cause discomfort (such as blinking, or being in an air-conditioned room) can cause a sensation of pain – sometimes severe.
Why grade eye pain?
At The Eye Practice, we see new people with severe dry eyes every week. They often travel from interstate and will usually have seen several dry eye specialists before they come to us. One of the first things we do, as part of our initial work-up is to grade their pain. This includes a self-assessment of the level of pain they experience on a daily basis (such as in the chart pictured).
Why does it matter?
By taking a baseline measurement of the pain, we can track your progress over time as treatment kicks in. If you start off at 6, and after a few months of treatment your pain is now at 3, you can see that progress is happening even if the symptoms haven’t disappeared.
Your eye pain may sometimes be accompanied by pain in other areas served by the same main nerve, including headaches and pains in the eye sockets, face, and neck. Light sensitivity can also be present and cause distress.
If so, you may be suffering from a pain syndrome. This can be highly debilitating even though your eyes look fairly normal when they’re examined.
What can be done?
Accurate diagnosis of underlying causes of your dry eye disease and appropriate treatment can relieve or reduce symptoms of eye pain in the majority of people we see at our dry eye practice.
Tired of putting up with eye pain? Talk to the experts. Call The Eye Practice on (02) 9290 1899 or make an appointment online today.
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