Ocular surface pain is a common cause of visits to eye care practitioners, frequently presenting within the scope of other ocular conditions such as dry eye, with substantial implications on global quality of life and healthcare cost.

Ocular surface pain may arise directly from tissue damage at the ocular surface or from changes to peripheral or central nerves in the ocular surface sensory pathway.

The trigeminal subnuclei have emerged as significant players in the modulation of ocular surface sensations, as explored in several animal models.

Several risk factors have been associated with ocular surface pain, including Sjögren’s, graft versus host disease, migraine, fibromyalgia, refractive surgery, and environmental conditions.

The treatment of refractory chronic ocular surface pain should address the underlying contributors in an individual patient. In some cases, the use of therapies that modulate nerve function should be considered.