A study led by the Singapore Eye Research Institute, comparing the quality of life (QoL) and symptomatology of neuropathic corneal pain (NCP) and dry eye disease (DED), found NCP was more debilitating, leading to more severe and frequent symptoms and greater negative impact on all aspects of QoL. 

“Both NCP and DED have a profound impact on patients' vision-related and overall QoL, including physical, social, psychological and workplace productivity aspects,” reported the research team in Cornea. “Furthermore, suboptimal management also negatively affects patients’ QoL. Hence, it is essential to understand the extent of NCP and DED symptoms and their impact on various aspects of QoL.” 

The cross-sectional study included 100 patients with DED and 50 patients with NCP (diagnosed as having persistent neuropathic ocular pain or pain-like symptoms). Patients with NCP demonstrated significantly lower Oxford and National Eye Institute scores for ocular surface and corneal staining, respectively, and better tear breakup time than patients with DED. But they also reported significantly worse scores on the Ocular Pain Assessment Survey and Ocular Surface Disease Index, significantly more frequent vision-related function impairment and painful or sore eyes and significantly worse QoL in all aspects of daily living than the DED group.  

The study found pain affected QoL more significantly for NCP patients compared with DED patients, with burning sensation and photophobia the two most common symptoms reported to significantly bother NCP patients. Thus, these can be used as potential differentiating factors between NCP and DED, said the research team. “Future work should focus on elucidating the relationship between molecular profiles and symptomatology, the association between multiple social determinants and comparing symptomology pre-treatment and post-treatment symptomology to optimise diagnosis and management.”