Skip to main content

  • Gabapentin Reduces Dry Eye Pain in Some Patients

    By Lynda Seminara
    Selected By: Prem S. Subramanian, MD, PhD
    Add to My Bookmarks

    Journal Highlights

    Journal of Clinical Medicine
    2020;9(11):3765

    Download PDF

    Oral gabapentin is a first-line treatment for chronic systemic neuropathic pain. Although it has been used for ocular discomfort after refractive surgery and in severe, painful dry eye syndrome (DES), it can depress the central ner­vous system. As a result, some physi­cians are reluctant to prescribe it for neuropathic ocular pain (NOP) that doesn’t respond to topical treatment. Yoon et al. assessed the response to gabapentin among patients with DES who had signs of NOP. They found that some patients may benefit from gabapentin.

    For this study, the authors reviewed medical records for 35 patients with DES plus NOP. Patients underwent clinical exams of the tear film, ocular surface, and meibomian glands, and they completed the Ocular Pain As­sessment Survey (OPAS). One month into topical treatment with eyedrops, the decision to add gabapentin was made in accordance with ratings on an additional pain rating scale.

    Patients were grouped by response to treatment: Group 1 responded to eyedrops alone (n = 11), group 2 respond­ed to eyedrops plus gabapentin (n = 13), and group 3 did not respond to either regimen (n = 11).

    With regard to clinical findings, while those in group 1 had no history of systemic comorbidity, ocular sur­gery, or trauma, they had the poorest corneal staining scores. Those in group 2 had the highest incidence of systemic comorbidities (defined as rheumato­logic, neurologic, and psychological). Both groups 2 and 3 included patients who had a history of ophthalmic procedures such as cataract surgery or LASIK. Finally, those in group 3 were more likely than those in group 2 to experience pain in response to me­chanical or chemical stimuli. Only one patient experienced an adverse effect from gabapentin (mild tremor).

    The growing prevalence of DES has emphasized the need for effective management strategies, the authors said.

    Findings of this study demonstrate that certain subsets of patients with DES and NOP may benefit from add-on gabapentin treatment, particularly if they have systemic comorbidities, healthy corneas, and no history of sur­gery or other trauma.

    The original article can be found here.