Challenge the Pain

What is Chronic Ocular Surface Pain?

William F. Wiley, MD; and Jacqueline Theis, OD, FAAO, FNAP

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Ophthalmologist William F. Wiley, MD, and Optometrist Jacqueline Theis, OD, FAAO, FNAP, describe a common eye disease that impacts patients’ lives and brings them into clinic: Chronic Ocular Surface Pain (COSP). Dr. Wiley and Theis discuss the pathophysiology, types and sources of COSP, how it overlaps with dry eye disease, the concept of “pain without stain”, and the importance of recognizing and accurately diagnosing this disease.

Posted: 6/25/2025

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What is Chronic Ocular Surface Pain?

William F. Wiley, MD; and Jacqueline Theis, OD, FAAO, FNAP

Ophthalmologist William F. Wiley, MD, and Optometrist Jacqueline Theis, OD, FAAO, FNAP, describe a common eye disease that impacts patients’ lives and brings them into clinic: Chronic Ocular Surface Pain (COSP). Dr. Wiley and Theis discuss the pathophysiology, types and sources of COSP, how it overlaps with dry eye disease, the concept of “pain without stain”, and the importance of recognizing and accurately diagnosing this disease.

Posted: 6/25/2025

About CHRONIC OCULAR SURFACE PAIN (COSP)

Many eye care patients may have Chronic Ocular Surface Pain (COSP), defined as a feeling of pain originating from the ocular surface that persists for more than three months⁴. COSP is often overlooked or misdiagnosed. It’s important to learn how to diagnose COSP in your practice.

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