Abstract
Persistent pain in the eyes after LASIK may be caused by diverse and complex pathophysiological mechanisms that involve interactions between the cornea and somatosensory, optic, and autonomic neural circuits.
1
A sensitized peripheral and central nervous system may be the main contributing factor to pain and sensitivity to light.
2
Not infrequently, various mechanisms coexist, such as in cases of concomitant inflammatory and neuropathic contributors to pain. Yet, in most chronic cases, centralized pain as a result of sensitization and hyperexcitability of central neurons, subsequent to nociceptive input, may further contribute to chronicity and intractability of pain. High prevalence of other chronic painful and/or psychiatric illnesses or cognitive-behavioral abnormalities in patients with pain in the eyes further confound their diagnostic and therapeutic approach. These considerations highlight the need for interdisciplinary diagnostic and therapeutic approaches, involving eye and pain specialists, mental health specialists, physical therapists, and other health professionals.