OBJECTIVES

Chronic Ocular Surface Pain (COSP) is under-recognised, with no formal diagnostic criteria. COSP is reported in relation to ophthalmic diagnoses/co-morbidities (e.g. dry eye disease, refractive surgery), but also manifests as a standalone pain condition. The objective was to explore the patient experience of COSP.

METHODS

Qualitative, semi-structured, concept elicitation telephone interviews were conducted with US patients (N=24) and clinicians (N=3). Fifteen patients also completed a real-time daily diary app task about their experience of COSP over seven days. Verbatim transcripts were analysed in Atlas.Ti using thematic analysis.

RESULTS

Patients with varying demographic/clinical characteristics and underlying causes of COSP were recruited, including: corneal erosions/dystrophies (n=8/24), refractive eye surgery (n=7/24), and dry eye disease (n=6/24). Moderate pain was reported by 19 patients; severe/very severe pain by five. Most patients (n=19/24) reported experiencing pain four to six days per week.

Nine primary eye pain-related symptoms of COSP were reported, including; eye pain (n=24), eye itch (n=23), eye dryness (n=21), burning (n=21), and irritation (n=20). All patients reported secondary symptoms: vision-related (light sensitivity n=18, blurred vision n=14) and physical symptoms (eye redness n=21, inflammation n=17). Patients reported health-related quality of life impacts of COSP including: activities of daily living/visual tasking (including: reading n=24, use of digital devices n=23, driving n=22, leisure activities n=21, sleep disturbance n=12), emotional impacts (n=23; including: anger/frustration n=15, depression/sadness n=8, stress/worry n=7), social functioning (n=18) and work problems (n=15). There were no apparent differences in patient experiences based on underlying condition. App-task and clinician interview findings were consistent with patient interviews. A conceptual model was developed based on the findings.

CONCLUSIONS

This research provides an in-depth understanding of the patient experience of COSP. Findings informed the development of a patient-reported outcome measure to assess important eye-pain and related symptoms, functioning and impact concepts for use in clinical programs.