Painful blind eye: efficacy of enucleation and evisceration in resolving ocular pain

Shah-Desai, Sabrina; Tyers, A G; Manners, R M

doi:10.1136/bjo.84.4.437

Cited by 66 publications

(53 citation statements)

References 3 publications

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“…Their study was based on an e-mail follow-up with 58 patients in 1999 (Custer & Reistad 2000). A retrospective study by Shah-Desai et al (2000) indicated that there was pain relief for all 24 patients treated with enucleation or evisceration.…”

Section: Identification Of Risks Factors For Developing Phantom Painmentioning

confidence: 99%

“…Possible aetiologies and treatments have been discussed in case reports (Glatt et al 1993;Waldman 1994;Kristinsson et al 1997). Specific causes of pain from the anophthalmic socket have been suggested: the need for modification or polishing of the prosthesis, conjunctival cysts, migration of the implant, lacrimal insufficiency, inflammatory or infectious conditions, tumours, haematoma, residual silicone band, amputation neurinomas, diseases of the brain and sinuses, compression or irritation of the trigeminal nerve and psychiatric causes (Glatt et al 1993;Shah-Desai et al 2000). Reflex sympathetic dystrophy has also been suggested as a cause for anophthalmic socket pain (Waldman 1994).…”

Section: Introductionmentioning

confidence: 99%

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Phantom pain after eye amputation

Rasmussen¹,

Prause²,

Toft³

2010

Acta Ophthalmologica

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ABSTRACT.Purpose: To characterize the quality of phantom pain, its intensity and frequency following eye amputation. Possible triggers and relievers of phantom pain are investigated. Methods: The hospital database was searched using surgery codes for patients who received ocular evisceration, enucleation, orbital exenteration or secondary implantation of an orbital implant in the period between 1993 and 2003. A total of 267 patients were identified and invited to participate; of these, 173 agreed to participate. These patients' medical records were reviewed. A structured interview focusing on pain was conducted by a trained interviewer. Results: Of the 173 patients in the study, 39 experienced phantom pain. The median age of patients who had experienced phantom pain was 45 years (range: 19-88). Follow-up time from eye amputation to participation in the investigation was 4 years (range: 2-46). Phantom pain was reported to be of three different qualities: (i) cutting, penetrating, gnawing or oppressive (n = 19); (ii) radiating, zapping or shooting (n = 8); (iii) superficial burning or stinging (n = 5); or a mixture of these different pain qualities (n = 7). The median intensity on a visual analogue scale, ranging from 0 to 100, was 36 (range: 1-89). One-third of the patients experienced phantom pain every day. Chilliness, windy weather and psychological stress ⁄ fatigue were the most commonly reported triggers for pain. Conclusions: Phantom pain after eye amputation is relatively common. The pain appears to be similar to the phantom pain suffered by limb amputees. Patients should be informed about this potential complication before surgery.

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Section: Identification Of Risks Factors For Developing Phantom Painmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Phantom pain after eye amputation

Rasmussen¹,

Prause²,

Toft³

2010

Acta Ophthalmologica

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“…After the surgery, the mean VAS decreased to 2.88 with measuremanagement of ocular pain is complex and requires a multidisciplinary approach involving specialties such as anaesthesiology, ophthalmology, neurology and at times a specialized psychologist (7). Retrobulbar alcohol injection is a viable option for pain relief in patients who have cosmetically acceptable eyes as well as those who are either unwilling or unfit for more extensive surgery and subsequent management (8). Also, cyclocryotherapy provides good intraocular pressure control and good pain control.…”

Section: Resultsmentioning

confidence: 99%

The last option for pain management - combined cryo-technique in blind eyes with absolute glaucoma

Marinov

Neykova

Grupchev

et al. 2017

SSM

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AIM:To evaluate the efficiency and safety of simultaneous, combined cryotherapy and alcohol injection in cases of secondary neovascular glaucoma with absolute vision loss and intolerable pain syndrome. Ocular pain due to glaucoma can be complex and difficult to treat. Therapy consists of topical and systemic pressure lowering agents, anti-inflammatory drugs, analgesics, surgical procedures -cyclocryotherapy, retrobulbar alcohol injection, enucleation or evisceration. MATERIALS AND METHODS:We present 35 patients diagnosed with absolute glaucoma and treated with a combined technique -cyclocryotherapy and retrobulbar alcochol 96% 1ml injection. Verbal Analog Score (VAS) was used to evaluate the pain. RESULTS:All of the patients (100%) were pain-free 12 months after the procedure. No significant longterm complications were observed. CONCLUSION:This case study highlights that cyclocryotherapy combined with retrobulbar alcohol can play a significant role in the management of pain in patients with absolute glaucoma.

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“…[2] The injection of chemical neurolytic agents to the retrobulbar area is an alternative method for cases having a poor general health status for this surgery or having psychological, social, or religious reasons. [3,5] Alcohol injection to the retrobulbar area came up in the 1900s as an alternative method to enucleation. [21] It was thought to affect both coagulation in the nerve fibrils and damages that emerge with lipid precipitation.…”

Section: Discussionmentioning

confidence: 99%

“…[3] Surgical removal of the eye is a prominent traditional treatment for resistant severe pain, if the level of vision is too poor. [4] However, the local application of some agents for neurolysis can be an alternative treatment if the patient has any psychological or medical concerns or enucleation or evisceration.…”

Section: Introductionmentioning

confidence: 99%

Pain Management by Retrobulbar Alcohol Injection in Blind Painful Eyes Due to Late-Stage Neovascular Glaucoma

Şalkacı¹

2017

South Clin Ist Euras

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Objective: This study aimed to evaluate the efficacy of retrobulbar alcohol injections using the verbal analog scale (VAS) in patients with blind painful eyes due to late-stage neovascular glaucoma. Methods:A total of 20 eyes with severe pain due to neovascular glaucoma were injected with 95% ethyl alcohol in the retrobulbar area. On the basis of the number of injections, the patients were separated into group 1 (1 injection) or group 2 (≥2 injections). Pain scores and complication rates were compared between the two groups. Results:The pre-injection median VAS score was 9.00±0.61 with no difference between the two groups. On post-injection day 1, no difference was found in the median VAS scores between the two groups, although significant intergroup differences appeared at 1 and 6 months. Seven patients with VAS scores ≥5 in the follow-up were given additional injections. Four patients whose pain was not relieved after three injections underwent evisceration after 6 months. The median VAS scores were significantly lower in all patients at 12 months compared with the baseline. No difference was observed in the median VAS scores between the groups at the final follow-up. Complications included ptosis in five eyes and severe conjunctival chemosis in nine eyes. Conclusion:Retrobulbar alcohol injection is a safe and effective method for managing patients with neovascular glaucoma having severe pain that is refractory to medical treatment.

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Painful blind eye: efficacy of enucleation and evisceration in resolving ocular pain

Cited by 66 publications

References 3 publications

Phantom pain after eye amputation

Phantom pain after eye amputation

The last option for pain management - combined cryo-technique in blind eyes with absolute glaucoma

Pain Management by Retrobulbar Alcohol Injection in Blind Painful Eyes Due to Late-Stage Neovascular Glaucoma

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