A case of dry eye neurosensory pain

Clinical Practice
Optometrist Dr Keyur Patel presents another challenging case from his practice, this time concerning a patient with a long history of ocular surface disease

Initial presentation

A 30-year-old male presented for a scleral contact lens fitting as part of the management of his long standing ‘dry eye’ problems. Scleral contact lenses had been suggested as a potential management option at his last eye examination by a colleague at another practice.

At present his only management was the use of Systane Gel Drops as needed, which in practice might be as frequent as every 10 minutes.

Key points from his history included the following;

Clinical assessment

Initial clinical findings are summarised in table 1.

Table 1: Clinical findings at first presentation to author

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