A scoping review of pharmacologic and non-pharmacologic interventions to treat chronic ocular pain

Abstract

Objective: The objective of this scoping review is to understand the extent and evidence for both pharmacologic and non-pharmacologic treatments to address chronic ocular pain (COP). We aim to summarize the evidence for COP therapeutics and highlight gaps in the current evidence to help direct both evidence-based clinical care and future research efforts. Introduction: COP is disabling and a common reason for referral to neuro-ophthalmologists. Many patients with COP suffer from amplified or dysfunctional pain processing in the central nervous system, rather than a problem with the eye itself. The extent and evidence for therapeutic interventions targeting pain processing in the CNS among patients suffering from COP is unknown. Methods: We will perform a search of Ovid MEDLINE, Embase, Scopus, and Clinicaltrials.gov. We will limit our search to English language articles published since 2015. We will include observational and experimental studies of pharmacologic and non-pharmacologic interventions (e.g., vagal nerve stimulation) used in adults 18 years or older with COP for at least 3 months. Studies will be included if impact on pain intensity, functioning, or quality of life are measured as primary, secondary, or exploratory outcomes. All articles will be independently screened by two team members for inclusion. Data extraction will be performed independently by two team members. Any disagreements during the screening and data extraction process will be adjudicated by a third team member and discussed as a group. Results and Conclusion: The results will be reported using the PRISMA-ScR checklist and submitted for publication in a peer-reviewed journal.