Retrobulbar Chlorpromazine Injections for the Management of Blind and Seeing Painful Eyes

Chen, Teresa C.; Yuen, Sonia J. Ahn; Sangalang, Marither A; Fernando, Ronaldo E; Leuenberger, Edgar U.

doi:10.1097/00061198-200206000-00008

Cited by 34 publications

(24 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[9][10][11]25,26] Both of them caused less pain compared with alcohol, and they acted faster in alleviating the pain. [9,11] Very few studies on either alcohol or other neurolytics use are available. The characteristics of neurolytic agents that make them better than other methods are that they are more comfortable, their effect length is shorter, and they are cheaper.…”

Section: Discussionmentioning

confidence: 99%

“…[5] It has been reported that some agents such as ethyl alcohol, phenol, or chlorpromazine are effective from 2 weeks to 2 years in 30%-87% of the cases. [5][6][7][8][9][10][11] This study aimed to evaluate the severity and complications of the retrobulbar ethyl alcohol injection in patients Original Article having NVG-dependent therapy-resistant severe pain using the verbal analog scale (VAS).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Şalkacı¹

2017

South Clin Ist Euras

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

show abstract

“…If conservative measures do not result in improved comfort for the patient, then pain can be relieved with retrobulbar injection of chlorpromazine55 or absolute alcohol. If this is not effective, or there is a cosmetic concern, then evisceration or enucleation can be considered with an ocular prosthesis as appropriate.…”

Section: Blind Painful Eye(s) With Glaucomamentioning

confidence: 99%

Advanced glaucoma: Management pearls

Gessesse

Damji

2013

Middle East Afr J Ophthalmol

View full text Add to dashboard Cite

A significant proportion of glaucoma patients present late, particularly in the developing world, and unfortunately, in an advanced stage of the disease. They are at imminent danger of losing remaining vision, and may also be afflicted with various socioeconomic and health challenges. The encounter with such a patient is typically characterized by anxiety/fear and sometimes hopelessness from the patient's perspective. The physician may also feel that they are in a difficult position managing the patient's disease. When dealing with such cases, we suggest a holistic, individualized approach taking into account the ‘biopsychosociospiritual’ (BPSS) profile of each patient. The BPSS model takes into account relevant ocular as well as systemic biology (factors such as the mechanism of glaucoma, level of intraocular pressure [IOP], rate of progression, life expectancy, general health), psychological considerations (e.g., fear, depression), socio-economic factors and spiritual/cultural values and beliefs before being able to decide with the patient and their care partner(s) what treatment goals should be and how they can best be approached. Treatment for advanced glaucoma can be highly effective, and patients and their care partners should be informed that aggressive IOP lowering to the low teens or even single digits offers the best chance of protecting remaining vision. This can be achieved safely and effectively in most cases with trabeculectomy (including an antimetabolite), and in some cases with medical and/or laser therapy. Vision rehabilitation and psychosocial support should also be considered in order to optimize remaining vision, replace fear with hope as appropriate, and thus improve the overall quality of life.

show abstract

“…Pain can, at times, be controlled with a retrobulbar injection of alcohol or chlorpromazine 57–59. Corneal-related discomfort can, in select cases, be managed with a conjunctival flap 60–64…”

Section: Indicationsmentioning

confidence: 99%

Evisceration in the modern age

Phan

Hwang

McCulley

2012

Middle East Afr J Ophthalmol

View full text Add to dashboard Cite

Evisceration is an ophthalmic surgery that removes the internal contents of the eye followed usually by placement of an orbital implant to replace the lost ocular volume. Unlike enucleation, which involves removal of the entire eye, evisceration potentially causes exposure of uveal antigens; therefore, historically there has been a concern about sympathetic ophthalmic (SO) associated with evisceration. However, critical review of the literature shows that SO occurs very rarely, if ever, as a consequence of evisceration. Its clinical applications overlap with those of enucleation in cases of penetrating ocular trauma and blind painful eyes, but it is absolutely contraindicated in the setting of suspected intraocular malignancy and may be preferred for treatment of end-stage endophthalmitis. From a technical standpoint, traditional evisceration has a limitation in the orbital implant size. Innovations with scleral modification have overcome this limitation, and accordingly, due to its simplicity, efficiency, and good cosmetic results, evisceration has once again been gaining popularity.

show abstract

Retrobulbar Chlorpromazine Injections for the Management of Blind and Seeing Painful Eyes

Abstract: Retrobulbar chlorpromazine appears to be safe and effective for the management of pain in blind eyes.

Cited by 34 publications

References 7 publications

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

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

Advanced glaucoma: Management pearls

Evisceration in the modern age

Contact Info

Product

Resources

About