Neuromodulatory interventions, which target sensory trigeminal and central pain pathways, may help treat chronic ocular pain. A recent study decided to evaluated the long-term effects specifically of a trigeminal neurostimulator (TNS) on ocular pain.

Eighteen individuals with chronic, severe ocular pain who were prescribed and used TNS at home for three months or longer. The primary outcome measures were side effects and ocular symptom intensity over a 24-hour recall period that captured pre-TNS and at monthly follow-up intervals.

At six months, pain intensity decreased by 31.4%, light sensitivity decreased by 36.3% wind sensitivity decreased by 32.6% and burning sensation decreased by 53.9%, and greater decreases in ocular pain were noted in individuals with migraines than those without. Fifteen individuals experienced sedation with TNS use, which persisted throughout the follow-up visits.

“These improvements in symptoms did not occur immediately in most participants, frequently taking at least two months to show significant decreases from baseline followed by increased improvement over time,” the authors explained in their study. They also noted that findings regarding ocular pain symptoms were similar to data on prophylactic treatment of migraine using the same device.

“Furthermore, in our study, individuals with concomitant migraine had greater reductions in symptom scores compared to individuals without migraine, suggesting that ocular pain in these individuals can be effectively treated with therapies currently in use for migraine, thus addressing both headache and ocular symptoms,” they wrote. “In summary, we demonstrate benefits of TNS in reducing ocular symptoms with prolonged device use with added efficacy in individuals with concomitant migraine headaches.”

Mehra D, Mangwani-Mordani S, Acuna K. Long-term trigeminal nerve stimulation as a treatment for ocular pain. Neuromodulation. 2021. Epub ahead of print.