When dry eyes turn into chronic eye pain, it may no longer be just a tear problem. Severe dry eye can evolve into neuropathic eye pain and neurotrophic keratitis due to corneal nerve damage and trigeminal nerve dysfunction.

Why do some people have intense eye pain with a normal exam, while others have corneal damage but feel nothing?

Dr. Joseph Allen is joined by cornea specialist Dr. Laura Periman and neuro-optometrist Dr. Jacqueline Theis to break down the science behind chronic ocular pain.

In This Episode You Will Learn

✅ Why dry eye can become chronic eye pain

✅ The role of inflammation in corneal nerve damage

✅ How neuropathic eye pain develops

✅ What neurotrophic keratitis really means

✅ Why anti-inflammatory treatment alone may not work

✅ How concussion and brain injury affect dry eye symptoms

✅ The connection between TMJ, neck tension, and eye pain

✅ Why chronic ocular pain needs emotional and sleep support

Subscribe to the Doctor Eye Health Podcast for trusted vision care education and expert insights that help you understand the powerful connection between lifestyle choices and your eye health.

Timestamps

00:00 When dry eye becomes chronic eye pain

02:21 Inflammation and corneal nerve damage

03:18 Neurosensory dry eye after brain injury

06:27 How the trigeminal nerve connects eye and brain

12:32 Chronic inflammation and hyperalgesia

17:17 Neurotrophic keratitis vs neuropathic pain

21:35 Trigeminal neuralgia and nerve treatment

23:12 Botox, bruxism, and referred eye pain

27:11 Proparacaine challenge test explained

35:07 Pain management medications and PRP

37:06 Anxiety, sleep, and chronic ocular pain

👀 Watch: My Struggle with Dry Eyes https://youtu.be/sE-IRvy8d6o?si=6EbpBBaOFRtxrpLe

Key Takeaways

🔹 Dry eye can progress into chronic eye pain when corneal nerves become damaged

🔹 Neuropathic eye pain may exist even when the eye surface looks normal

🔹 Neurotrophic keratitis may cause damage without pain

🔹 Chronic ocular pain requires a team-based approach

About the Guests:

Dr Laura Periman Dry Eye Master

Board-certified ophthalmologist

Cornea and refractive surgery fellowship trained

Founder, Perryman Eye Institute, Seattle

LinkedIn: https://www.linkedin.com/in/lauraperiman/

Website: https://dryeyemaster.com/about-laura-periman/

Jacqueline Theis, OD, FAAO, FNAP

Residency-trained neuro-optometrist

Specialist in brain injury and neurosensory dysfunction

Practicing within a multidisciplinary brain injury center in Richmond, Virginia

LinkedIn: https://www.linkedin.com/in/jacqueline-theis-od-faao/

Website: https://concussioncarecentre.com/traumatic-brain-injury-specialists/jacqueline-theis/

Resources Mentioned

Website: Doctor Eye Health https://www.doctoreyehealth.com/

YouTube: Doctor Eye Health https://www.youtube.com/@DoctorEyeHealth

Instagram: @doctoreyehealth https://www.instagram.com/doctoreyehealth

TikTok: Doctor Eye Health https://www.tiktok.com/@doctoreyehealth

Facebook: Doctor Eye Health https://www.facebook.com/DoctorEyeHealth

LinkedIn: Dr. Joseph Allen https://www.linkedin.com/

DISCLAIMER: All content in this video and description including infor­ma­tion, opinions, con­tent, ref­er­ences, and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing, or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and its author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or its description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­mu­nity in all mat­ters relat­ing to your health.

dry eye, chronic eye pain, dry eye pain, severe dry eye, burning eyes, eye pain causes, painful dry eyes, neuropathic eye pain, neurotrophic keratitis, corneal nerve damage, ocular surface disease, trigeminal nerve eye pain, chronic ocular pain, why does dry eye hurt, eye pain but normal exam, chronic eye pain after dry eye, severe eye pain that will not go away, dry eye inflammation, brain injury dry eye symptoms, why do my eyes hurt, severe eye pain no redness, stabbing eye pain, eye pain not improving with drops, dry eye that won’t go away, constant eye pain