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Chronic ocular surface pain (COSP), defined as ocular surface pain lasting more than three months, has traditionally been classified under \u201cdry eye disease.\u201d However, emerging evidence suggests that in a subset of individuals, COSP shares important clinical and mechanistic features with COPCs, supporting the need for an updated synthesis as increasing data implicate central contributions to pain. This narrative review examines COSP within the broader COPC framework across epidemiology, risk factors, pathophysiology, diagnosis, and treatment, and proposes that in select cases, COSP may warrant conceptual consideration as an additional COPC. Across the literature, COSP shares several similarities with COPCs, including high prevalence, female predominance, and increasing frequency with age. Chronic ocular surface pain also commonly clusters with COPCs and, when nociplastic features are present, is associated with psychosocial comorbidity. Mechanistically, COSP in some individuals demonstrates characteristics of nociplastic pain, including symptom\u2013sign discordance, persistent pain despite topical anesthesia, multisite hyperalgesia, and altered functional connectivity within central pain and sensory processing networks. Collectively, current evidence supports substantial overlap between COSP and COPCs within a nociplastic framework, suggesting that COSP may be best understood, in part, within this broader construct. Recognizing COSP in the context of COPCs has important implications for mechanism-based approaches to diagnosis, treatment, and future research aimed at improving outcomes.<\/jats:p>","DOI":"10.1007\/s40265-026-02343-9","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T16:46:38Z","timestamp":1781109998000},"page":"1285-1306","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Chronic Ocular Surface Pain: A Missing Member of the Chronic Overlapping Pain Conditions?"],"prefix":"10.1007","volume":"86","author":[{"given":"Jonghoon","family":"Chang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Hattenhauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Saccaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferida","family":"Mamatkazina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Felix","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"De Lott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3026-6155","authenticated-orcid":false,"given":"Anat","family":"Galor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"2343_CR1","doi-asserted-by":"publisher","unstructured":"Raja SN, Carr DB, Cohen M, et al. 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J.C. drafted the manuscript. J.C., A.H., L.S., F.M., E.F., L.DL., and A.G. contributed to analysis and interpretation of the literature and to critical revision of the manuscript for important intellectual content. J.C. and F.M. created tables and figures. A.G. provided supervision. A.G. and L.DL. acquired funding. All authors contributed to the manuscript, including revisions and edits. All authors have read and approved the final version of the manuscript.","order":6,"name":"Ethics","label":"Authors\u2019 contributions","group":{"name":"EthicsHeading","label":"Declarations"}}]}}