Treatment of Ocular Neuralgia After Refractive Surgery With Bilateral Orbital Steroid and Anesthetic Injections

Title

Treatment of Ocular Neuralgia After Refractive Surgery With Bilateral Orbital Steroid and Anesthetic Injections

Creator

Yalamanchili S P; Hertle R W

Publisher

Journal of Refractive Surgery

Date

2019
2019-08

Description

PURPOSE: To describe a patient with chronic periocular pain after bilateral photorefractive keratectomy (PRK), termed ocular neuralgia, that was controlled with regular orbital steroid and anesthetic injections. METHODS: Case report. RESULTS: A 21-year-old man presented 3 months following bilateral PRK surgery in severe bilateral orbital pain. Previous treatments included topical (artificial tears, corticosteroids, and nonsteroidal anti-inflammatory drugs [NSAIDs]) and oral (NSAIDs, opioids, and pregabalin) therapies with minimal pain relief. A bilateral orbital triamcinolone acetonide 40 mg/cc and 0.25% bupivacaine injection was done after a successful, diagnostic unilateral 0.25% bupivacaine injection. Following bilateral bupivacaine and triamcinolone acetonide injections, pain intensity improved from 7 to 9 to 1 to 3 (out of 10). Repeat injections have been regularly performed over the past 3 years, allowing the patient to experience improved symptoms lasting from 4 to 9 months. CONCLUSIONS: Regular orbital nerve blocks can provide relief from neuralgic ocular pain and may be considered as a potential treatment option after failure of medical management.

Subject

efficacy; management; Neuropathic pain; Ophthalmology; Surgery

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Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

534-537

Issue

8

Volume

35

Citation

Yalamanchili S P; Hertle R W, “Treatment of Ocular Neuralgia After Refractive Surgery With Bilateral Orbital Steroid and Anesthetic Injections,” NEOMED Bibliography Database, accessed March 1, 2021, https://neomed.omeka.net/items/show/6490.

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