Conclusions
Dry eye has gained recognition as a public health problem given its prevalence, morbidity, and cost implications. Although dry eye was initially thought to be a 'simple' disease of tear dysfunction, exciting new research has revealed that it is a complicated disorder with potentially complex neuropathologic mechanisms. In fact, what we currently refer to as dry eye likely represents a heterogenous group composed of different disease subtypes with various levels of ocular sensory apparatus dysfunction.
Indeed, it is likely that a subset of dry eye patients have neuropathic pain and central sensitization. These patients are likely to be more resistant to topical therapy directed at optimizing the ocular surface. Differentiating between the different subgroups within dry eye and evaluating for the presence of neuropathic ocular pain will be critical to individualizing the treatment of dry eye.
Acknowledgements
This paper was supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Clinical Sciences Research and Development's Career Development Award CDA-2-024-10S (to Dr Galor), NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant, Department of Defense (DOD- Grant no. W81XWH-09-1-0675), and NIH NIDCR R01 DE022903 (to Drs Levitt and Martin). In addition, we note that the contents of this study do not represent the views of the Department of Veterans Affairs or the US Government.
Eye. 2015;29(3):301-312. © 2015 Nature Publishing Group
