Abstract
Purpose :
Chronic ocular pain is a rare disorder in which examination findings are frequently unremarkable, and treatments are often ineffective, complicating patient care. The signs and symptoms are often out of proportion mimicking common neuropathic pain conditions, and studies incorporating this aspect are limited. Our study aims to determine the efficacy of a multidisciplinary, patient-centered approach, in the treatment of patients with chronic ocular pain.
Methods :
A longitudinal study with an original questionnaire was filled-out at the time of original presentation, and a follow-up questionnaire was administered online or via telephone. Questionnaires included the OSDI, Numeric Pain Scale, and effectiveness of various treatments and interventions. A paired t-test was used to determine significance.
Results :
One hundred fifty patients with chronic ocular pain were contacted, and 18 responses were received (12%). Average age of responders was 51±16 years, 72% were female, and the mean follow-up duration was 1.9±0.4 years. Average NRS score on presentation was 5.9±2.6 with a mean pain duration of 4.2 years, and improved to 4.1±2.6 (p=0.01), with improvement in the pain reported by 61% of patients. OSDI scores increased from 38.5±16.9 to 56.1±18.0 (p=0.003) with no correlation to change in NRS scores. Nine of 18 (50%) patients found their visits to ophthalmology to be helpful, 2/7 (29%) to neurology, 2/5 (40%) to functional medicine, and 2/5 (40%) to pain medicine. Sixteen/18 (89%) reported improvement with eyedrops, 7/13 (54%) with systemic medications, and 18/18 (100%) with non-pharmacologic interventions.
Conclusions :
A multidisciplinary approach is needed in the management of patients with chronic ocular pain. A patient-centered team approach with ophthalmology, neurology, functional medicine, and pain medicine practitioners is beneficial optimizing the management of these challenging patients.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.