Ocular Pain Symptoms in Individuals With and Without a History of Refractive Surgery: Results From a Cross-Sectional Survey

Abstract

Purpose: This study characterized ocular pain symptoms in individuals with and without a history of refractive surgery (RS) using a cross-sectional survey of individuals with ocular pain.

Methods: A link to an anonymous survey was posted on a corneal neuralgia Facebook group that included individuals with ocular pain from any etiology and sent to individuals seen in our clinic with ocular pain. The survey asked about medical history, ocular pain symptoms (using standardized questionnaires), and treatment responses. Respondents were split into 2 groups based on a history of RS.

Results: One hundred one individuals responded to the survey. The mean age for all respondents was 41.6 ± 15.6 years, and 50% reported a history of RS. A total of 46% of individuals with a history of RS reported that their ocular pain started within 1 month of surgery, with median pain duration of 36 (interquartile range 22-84) months. The median Dry Eye Questionnaire-5 (range 0-22) scores were 16 and 15 for the RS and no-RS groups, respectively. Most individuals in both groups characterized their pain as burning (score ≥1: RS, 86%; no-RS, 80%) and reported evoked pain to wind, light, or temperature (score ≥1: RS, 97%; no-RS, 85%). Fifty-nine of 101 individuals responded to treatment questions. Individuals in both groups reported >30% improvement in pain symptoms with some topical and systemic approaches.

Conclusions: Individuals with a history of RS developed ocular pain soon after surgery, which persisted for years. Symptom profiles were similar between those with and without RS. Topical and systemic approaches can treat pain in both groups.

Figure 1.. Frequency of time to ocular pain onset after refractive surgery.

X-axis is time to ocular pain onset grouped by time periods. Y-axis is frequency of responses. This graph includes participants who responded that their ocular pain started after refractive surgery (N=39).

Figure 2.. Treatment response in post-refractive surgery individuals (N=27).

Treatment response in respondents who had post-refractive surgery. A total of 27 post-refractive surgery individuals responded to treatment questions. The frequency of respondents that reported >30% improvement with a particular treatment is plotted on the X-axis. N=number of respondents who reported using the treatment; PROSE=prosthetic replacement of the ocular surface ecosystem; TENS=transcutaneous electrical nerve stimulation; PRP/PRGF=platelet-rich plasma/platelet-rich growth factor; NSAID=non-steroidal anti-inflammatory drugs.

Figure 3.. Treatment response in individuals without refractive surgery (N=32).

Treatment response in respondents who did not have refractive surgery. A total of 32 individuals without refractive surgery responded to treatment questions. The frequency of respondents that reported >30% improvement with a particular treatment is plotted on the X-axis. N=number of respondents who reported using the treatment. PROSE=prosthetic replacement of the ocular surface ecosystem; TENS=transcutaneous electrical nerve stimulation; PRP/PRGF=platelet-rich plasma/platelet-rich growth factor; NSAID= non-steroidal anti-inflammatory drugs.