Ocular pain can be multi-factorial and often refractory to treatment, in spite of the myriad options available to the ophthalmologist for its management. Initial therapy entails the use of topical and systemic pressure lowering agents as well as anti-inflammatory/analgesics for the provision of relief. Those refractory to medical therapy may require surgical intervention in the form of cyclodestructive procedures, retrobulbar injection of absolute alcohol and evisceration or enucleation. A case series of 5 patients of absolute glaucoma who were successfully treated with retrobulbar alcohol injection is reported. Pain was recorded on a verbal analogue score (VAS).All the patients were pain free twelve months after the injection. No significant long term complications were observed. This case series emphasizes the fact that retrobulbar alcohol injection can play an important role in the alleviation of pain in patients with absolute glaucoma.
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Vet Med Sci
November 2023
Dick White Referrals, Six Mile Botton, Cambridgeshire, UK.
J Med Case Rep
August 2022
Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450, Oslo, Norway.
Background: We describe a patient presenting with central retinal artery occlusion (CRAO) of the right eye after retrobulbar anesthesia with adrenaline for macular pucker surgery.
Case Presentation: The patient, a 67-year-old Caucasian man, developed a CRAO postoperatively by the next-day control likely due to the retrobulbar injection of a combination of Xylocaine and Bupivacaine with adrenaline as anesthetic.
Conclusions: The addition of adrenaline to the standard anesthetic solution could be a risk factor for serious complications, such as CRAO.
Orbit
August 2022
Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV), Deemed-to-beUniversity, Pondicherry, IndiabeUniversity, Pondicherry, India.
Purpose: To report the spectrum and the factors affecting the visual outcome of ocular injuries associated with maxillofacial trauma.
Methodology: A prospective observational study was carried out from January 2019 to June 2020 on patients of maxillofacial trauma at a rural tertiary care centre, in Pondicherry, India. Detailed history was obtained.
J Vet Intern Med
May 2021
Veterinary Medical Teaching Hospital, University of California-Davis, School of Veterinary Medicine, Davis, California, USA.
A 6-year-old neutered male German shepherd dog was evaluated for obtundation, blindness, and bilateral exophthalmos. A magnetic resonance imaging scan of the brain was performed and identified an arteriovenous malformation (AVM) with several feeding arterial branches, and venous drainage through the cavernous sinus. Venous vessels rostral to the AVM were severely distended and extended into the retrobulbar spaces.
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July 2021
Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, UK; Department of Ophthalmology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Alcohol (ethanol) has been used in medicine since time immemorial. In ophthalmic practice, besides as an antiseptic, it was given as retrobulbar injections to relieve severe ocular pain. Alcohol can be applied topically to the surface of neoplastic or suspicious lesions to kill cells that might desquamate and seed during surgical excision, to treat epithelial ingrowth that can occur following corneal surgeries, particularly laser in situ keratomileusis (LASIK), and to treat superficial infectious keratitis.
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