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Tufts University (Boston) Experts’ Opinion:

LDN now recommended as treatment for neuropathic corneal pain (NCP).

A new indication for the use of low dose naltrexone (LDN) has recently been recommended by leading authorities from the Tufts University School of Medicine. In a comprehensive review article published in the American Academy of Ophthalmology’s journal, “Ophthalmology”, an evidence-based approach to management strategies for NCP is presented. As part of this strategy, LDN is recommended as second line therapy (following the failure of the first-line therapies, tricyclic antidepressants and carbamazepine). The authors, Drs. Gabriela Dieckmann, Sunali Goyal, and Pedram Hamrah recommend starting with a dose of 1.5 mg daily at bedtime, and increasing it biweekly by 1.5 mg to a final maximum dose of 4.5 mg taken at bedtime.

…Drs. Gabriela Dieckmann, Sunali Goyal, and Pedram Hamrah recommend starting with a dose of 1.5 mg daily at bedtime, and increasing it biweekly by 1.5 mg to a final maximum dose of 4.5 mg taken at bedtime.

Eye Pain

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’ recommendation 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.