DOR OCULAR NEUROPÁTICA: MECANISMOS FISIOPATOLÓGICOS E ABORDAGENS TERAPÊUTICAS ATUAIS

Neuropathic ocular pain is a condition characterized by persistent ocular pain resulting from dysfunction or injury of the ocular somatosensory nervous system. Unlike nociceptive pain associated with inflammation or evident tissue damage, this type of pain may occur even in the absence of significant structural abnormalities of the ocular surface, making diagnosis and clinical management challenging. Recent evidence suggests that alterations in corneal nerve fibers, peripheral and central sensitization, and neuroinflammatory processes involving trigeminal pathways play a central role in its pathophysiology. This study aimed to review the main pathophysiological mechanisms involved in neuropathic ocular pain and discuss currently available therapeutic approaches. A narrative literature review was conducted using PubMed/MEDLINE, Scopus, Web of Science, and SciELO databases. The findings indicate that neuropathic ocular pain is associated with structural alterations in corneal nerves, persistent nociceptor activation, and central sensitization mechanisms. Therapeutic approaches include ocular lubricants, topical anti-inflammatory agents, and systemic neuromodulatory drugs. Understanding these mechanisms is essential to improve diagnosis and guide more effective treatment strategies.