Neurophysiologie de la douleur oculaire

Ocular surface diseases are among the most frequent ocular pathologies, with prevalence ranging between 15 and 25 % of the general population. Ocular surface diseases are often associated with chronic ocular pain, which impacts quality of life of tens of millions people worldwide. Unfortunately, little is known, about the pathophysiology of chronic ocular pain. As a result, there is no existing specific treatment against neuropathic pain in ophthalmology, since no specific targets have been identified so far. Thus, a better clinical characterization of chronic ocular pain and an understanding of the molecular and cellular mechanisms involved are crucial issues for developing effective management and therapeutic strategy to alleviate ocular pain. In this review, we describe the nociceptive corneal pain system including the corneal nociceptors and the peripheral and central structures participating in ocular pain transduction. Then, the experimental and clinical observations that have allowed to link ocular pain and inflammation are detailed. The last part of this review focuses on the diagnostic tools used in clinic to evaluate corneal sensitivity and ocular inflammation.