Abstract
Purpose :
We aim to differentiate pain perception and reported quality of life between neuropathic corneal pain (NCP) patients diagnosed with anxiety and/or depression and those without.
Methods :
This retrospective study included patients diagnosed with NCP at the New England Eye Center at Tufts Medical Center from 2015 to 2022. Primary inclusion was the clinical diagnosis of NCP based on examination, medical and surgical history, and nerve abnormalities seen by IVCM. Categorical variables were examined using Chi-square and Fisher’s exact tests. Mann Whitney U and Kruskal Wallis tests were used as appropriate to examine OSDI and OPAS questionnaire responses.
Results :
Of the 208 included patients, 73 (35.1%) were diagnosed with anxiety and/or depression. The mean ages were 44.2 and 48.1 years (P=0.139) for those with anxiety and/or depression and without, respectively. There was no significant difference in baseline pain level between the two groups, but patients with anxiety and/or depression did report increased pain with chemical exposure (P=0.014) and a burning sensation with their eye pain (P=0.004), as well as, significant impacts on sleep (P=0.005) and overall quality of life (P =0.0496). Of those with anxiety and/or depression, 43.8% were on psychiatric medication and reported a higher percentage of time thinking about non-eye pain (P=0.026), while those not taking any psychiatric medication reported pain affecting their mood more (P=0.026) and increased pain with chemical exposure (P=0.047). Although no significant differences in quality of life dimensions were noted, among medicated patients, those on non-SSRIs reported higher average pain over 24 hours (P=0.035), higher most pain (P=0.009), and average pain over 2 weeks (P=0.019).
Conclusions :
NCP patients with anxiety and/or depression were more likely to report ocular pain interfering with sleep and lowering their overall quality of life, along with increased pain with chemical exposure and a burning sensation. For patients on medications for anxiety and/or depression, their mood was less affected, pre-occupation with non-eye pain was increased. Additionally, SSRIs were shown to decrease pain levels over certain time periods. A psychogenic pain component could exist therefore, along with the physical for NCP patients with anxiety and/or depression, and should be considered when formulating a treatment plan.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.