Study: Is Gabapentin helpful for neuropathic pain plus severe dry eye?
This 72-patient study looks at the use of Gabapentin for patients who have BOTH severe dry eye AND neuropathic pain, and compares artificial tears + cyclosporine with artificial tears + cyclosporine + gabapentin. After 6 weeks, the gabapentin group were doing better.
In patient selection for this study… I am pondering exactly how you differentiate between neuropathic pain and pain from severe dry eye. it seems the only differential diagnostic criterion used for neuropathic pain was the painDETECT questionnaire. It’s very interesting.
Is gabapentin effective in dry eye disease and neuropathic ocular pain? Ongun et al, Acta Neurol Belg. 2019 May 27.
This study aims to evaluate the efficacy of gabapentin treatment in dry eye disease (DED) and neuropathic ocular pain. Our study was performed with 72 patients. The painDETECT questionnaire was used for neuropathic pain screening. Patients who were thought to have severe DED according to ocular surface disease index (OSDI) questionnaire, Schirmer's test type 1 and tear break up time test results were treated with artificial tear and cyclosporine drops. Gabapentin treatment was also initiated in addition to artificial tear and cyclosporine drops treatments to the patients with neuropathic component and DED findings. We divided the patients into two groups: group 1 (n: 36), patients treated with artificial tear and cyclosporine drops and group 2 (n: 36), patients treated with artificial tear, cyclosporine drops and gabapentin. In the first evaluation, no significant differences were found between groups in terms of OSDI score, Schirmer's test result and TBUT. After the 6 weeks of treatment, in both groups OSDI score, Schirmer's test result and TBUT statistically significantly improved. OSDI score, Schirmer's test result and TBUT significantly improved after the 6 weeks of gabapentin treatment than artificial tear and cyclosporine treatment group (p < 0.001). Dry eye patients should be screened for neuropathic ocular pain symptoms and individualized treatment has to be applied. Our study showed that the use of gabapentin is effective in severe dry eye patients with neuropathic ocular pain.