Hidden in Plain Sight: The Miscoding of Chronic Postsurgical Pain as Dry Eye Disease

ABSTRACT: Chronic postsurgical pain (CPSP) is a complication of cataract surgery. It is underrecognized and may be misdiagnosed as dry eye disease (DED). This retrospective case series presents three patients with no history of DED who developed CPSP after cataract surgery, but were misdiagnosed with DED for months or years. Despite these patients continuing to complain of persistent eye pain, their symptoms were dismissed as DED, delaying appropriate management. These cases highlight the challenges in recognizing CPSP and detrimental consequences of misdiagnosis as DED. In addition, these cases demonstrate that International Classification of Diseases codes for DED can serve as proxies allowing retrospective identification and investigation of CPSP in large databases, which in turn, may contribute to identification of risk factors, improved use of resources, and better outcomes for patients with CPSP after cataract surgery.