The purpose of this review is to discuss new findings on the epidemiology, pathogenesis, and treatment of neuropathic symptoms of the ocular surface, with an emphasis on possible parallels between dry eye, pain, and itch sensations. A narrative evaluation of the literature was carried out. Key sources from dry eye research, neuropathic ocular surface symptoms, ocular pain and itch, as well as general references on itch and pain neurobiology, were included. Recent research suggests that parts of dry eye, persistent ocular discomfort, and itch symptomatology are caused by neuropathic pain mechanisms that involve peripheral and central sensitization processes.
Ocular dryness, discomfort, and itch are common symptoms with numerous characteristics in common. Multiple lines of evidence indicate that peripheral and central neuronal sensitization processes play a role in the generation and maintenance of ocular sensory complaints. Research into the epidemiology of ocular sensations, molecular processes involved in nociception and pruriception in the eye, electrical changes in animal models of eye diseases, and treatment methods that might alleviate unpleasant visual sensations are all indicated.