B257 Pharmocological and acupuncture management of corneal neuropathy. A retrospective case study

Background and Aims Corneal Neuropathy is characterized by dysfunctional nerve endings of the corneal nerve. It causes allodynia and hyperalgesia leading to significant disability. Since corneal neuropathy is a recently described entity, management guidelines are still evolving. We present a case report where we combined pharmacological treatment with acupuncture Methods A 30 year old male presented with burning pain and dryness on both his eyes. The patient had previously undergone confocal microscopyand had been diagnosed with corneal neuropathy. The pharmacological treatment administered was: gabapentin1800 mg, duloxetine 60mg, tramadol 150mg and paracetamol 3gr per day. The acupuncture treatment was initiated 8 weeks later and consisted of one session per week for eight weeks with predetermined acupuncture points. The Ocular Pain Assessment Survey (OPAS) was used for quantifyingcorneal and ocular surface pain. Numerical rating scale was used to quantify pain and Global Perceived Effect Scale (GPE) was used to monitor the Global Effect of Recovery. Measurementswere taken at the beginning of the treatment, at the beginning and at the end of the acupuncture. Results OPAS questionnaireshowed more than 50% decreasein the non-eye related painand slightly less than 50% in the eye related pain. Both symptoms gradually decreased (30% with the pharmacological treatment and 50% when combined with acupuncture). Results were the same 8 weeks after treatment. NRS results were similar where the score on the GPE scalewas +3. Conclusions This case report could be an indicator that acupuncture seems to be an effective add on treatment for corneal neuropathy.