Comprehensive Review and Update of Burning Eye Syndrome

Authors

Stephen Giacomazzi, Creighton University School of MedicineFollow
Ivan Urits, Beth Israel Deaconess Medical Center; Harvard Medical SchoolFollow
Briggs Hoyt, Creighton University School of MedicineFollow
Ashley Hubble, Creighton University School of MedicineFollow
Elyse M. Cornett, Louisiana State University Health Sciences CenterFollow
Kyle Gress, Georgetown University School of MedicineFollow
Karina Charipova, Georgetown University School of MedicineFollow
Amnon A. Berger, Beth Israel Deaconess Medical Center; Harvard Medical SchoolFollow
Hisham Kassem, Mount Sinai Medical CenterFollow
Alan D. Kaye, Louisiana State University Health ShreveportFollow
Omar Viswanath, Envision Physician Services; University of Arizona College of Medicine-Phoenix; Creighton University School of MedicineFollow

Publication Date

7-19-2021

Keywords

burning mouth syndrome, neuropathy, ocular pain, chronic pain, lifitegrast, neuromodulation

Abstract

Keratoconjunctivitis sicca (“dry eye”) is a common (14%–30% of adults over age 48) though difficult to treat condition that causes both discomfort and disability with associated dryness, pain, and visual disturbances. Etiology is not clearly understood but is likely varied, with a subset of patients suffering from chronic neuropathic pain referred to as “burning eye syndrome.” This review of existing literature summarizes the clinical presentation, natural history, pathophysiology, and treatment modalities of burning eye syndrome.

Chronicity of burning eye syndrome is likely secondary to increased nociception from the cornea, decrease in inhibitory signals, and nerve growth factor expression alterations. Treatment centers around symptomatic alleviation and reduction of inflammation. Conservative treatments focus on well-being and perception and include exercise, acupuncture, and cognitive behavioral therapy. Topical treatment consists of the anti-adhesion T-cell antagonist lifitegrast, corticosteroids, and cyclosporine; all have moderate efficacy and good safety. Autologous serum eye drops are a second-line topical that may promote corneal and neural healing on top of symptomatic relief. When these treatments fail, patients may trial neuromodulation with transcranial magnetic stimulation. Despite general treatment safety, more research is needed to develop novel approaches to this condition, possibly focusing more directly on the neurological component.

Recommended Citation

Giacomazzi S, Urits I, Hoyt B, Hubble A, Cornett EM, Gress K, Charipova K, Berger AA, Kassem H, Kaye AD, Viswanath O. Comprehensive review and update of burning eye syndrome. J Patient Cent Res Rev. 2021;8:255-60. doi: 10.17294/2330-0698.1813