Autologous serum tears (AST) with concurrent use of In vivo confocal microscopy (IVCM) emerges as a highly effective management strategy to diagnose and monitor therapeutic response associated with neuropathic corneal pain, evident from a recently done retrospective case-control study.

A total of 16 participants with severe neuropathic corneal pain (NCP) resulted from corneal nerve damage were selected and received IVCM bilaterally. After treatment, patients were assessed for the change in pain severity, corneal nerve tortuosity, reflectivity, density, and the existence of microneuromas and beading.

All patients found to had severe pain of 9.1 ± 0.2. The sub basal nerves were reduced notably than controls, comprising total nerve length and a total number of nerves, respectively prior to the treatment initiation. A significant raised tortuosity and reflectivity, morphologically. Following 3.8 ± 0.5 months of AST therapy, a reduction was seen on the pain severity to 3.1 ± 0.3. Moreover, a notable improvement was seen in total nerve length and number and decline in tortuosity and reflectivity, diagnosed by IVCM. All these findings demonstrated a significant improvement in the patient symptoms of NCP with the implementation of AST-induced nerve regeneration.