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Tufts University (Boston) Experts’ Say:

LDN is a recommended treatment and focus of university research for neuropathic corneal pain (NCP).

A new indication (medical purpose) for low dose naltrexone (LDN) is recommended by leading authorities from the Tufts University School of Medicine. In a comprehensive article about evidence-based approaches to managing NCP, LDN therapy is recommended as second line therapy.

The authors, Drs. Gabriela Dieckmann, Sunali Goyal, and Pedram Hamrah suggest starting with a dose of 1.5 mg daily, and increasing it biweekly by 1.5 mg to a final maximum dose of 4.5 mg.

Treatment with low-dose naltrexone resulted in improvements in pain and quality of life scores without serious side effects among patients with neuropathic corneal pain

Dr. Gabriela Dieckmann and her Tufts University colleagues also presented the results of their 2019 study titled “Low-Dose Naltrexone is Effective and Well Tolerated in Patients with Neuropathic Corneal Pain” to the national body of ophthalmologists attending the American Academy of Ophthalmology annual meeting.

They analyzed the data of 30 patients with neuropathic corneal pain who were given at least 4 weeks of LDN in addition to their other medications, and who periodically rated their eye pain and quality of life. Nearly half of participants showed improvements in pain by at least 50%, and quality of life scores improved as well.

The poster they presented can be viewed in full here.

“Low-dose naltrexone can be effective as an adjunct treatment for neuropathic corneal pain,” Dr. Dieckmann has said. “We need to have placebo-controlled studies. We are trying to find the best treatment, the best solution, for our patients...and with low dose naltrexone, we saw an improvement in our patients.”

Neuropathic Corneal Pain is a debilitating disorder that can result from various conditions of the eye including dry eye syndrome, keratitis, erosion syndrome, radiation keratopathy, trauma, or eye surgery (including LASIK). It can also occur as a side-effect of medication or a complication from another systemic disease such as diabetes, fibromyalgia, lupus and other autoimmune diseases. It can also manifest in relation to anxiety, depression and PTSD.

Due to the large number of pain receptors in the cornea of the eye, the pain can be intense and can also manifest as perceptions of burning and stinging. Some patients describe the pain as “razors going across the eye” and some experience decreased vision as well. NCP is often not diagnosed as it can be purely subjective with no objective findings on physical examination.

This is the first time that LDN is being recommended for treating a primary eye disorder. It is hoped that these experts’ medical recommendation and their continued LDN research will lead to wide awareness of LDN in the ophthalmologic community, and as a result bring relief to numerous patients suffering from this painful and disabling eye disorder.

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