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Palliative Care3 papers

Blind boil

Last edited: 4/15/2026

Overview

Severe ocular pain in blind eyes, often due to conditions like end-stage glaucoma, uveitis, or corneal ulcer, can be refractory to conventional treatments. Retrobulbar alcohol injection is considered for pain relief when surgical interventions like enucleation or evisceration are not feasible.

Diagnosis

  • Key Diagnostic Criteria: Blind painful eye with intractable pain unresponsive to medical management 1.
  • Recommended Tests: Ophthalmic examination including visual acuity testing, intraocular pressure measurement, slit-lamp examination, and imaging studies as needed to identify underlying cause 1.

    • Management

  • First-Line Treatment: Medical management targeting underlying condition (e.g., glaucoma medications, anti-inflammatory drugs for uveitis) 1.
  • Adjunctive Treatment: Retrobulbar injection of absolute (96%) alcohol for pain relief in cases where medical management fails 1.
  • Specific Doses/Methods: Retrobulbar injection of absolute alcohol; effective pain relief duration varies from weeks to years (mean 29 weeks) 1.

    • Special Populations

  • Elderly: No specific considerations mentioned; treatment approach similar to general population 1.
  • Comorbidities: Management should consider coexisting conditions like glaucoma or uveitis, which influence the underlying pain etiology 1.

    • Key Recommendations

  • Consider retrobulbar alcohol injection for severe, intractable pain in blind eyes when other treatments are ineffective or not possible (Evidence: Weak) 1.
  • Monitor for transient complications such as blepharoptosis, external ophthalmoplegia, and corneal epithelial defects post-injection 1.
  • Ensure follow-up of at least three months to assess long-term efficacy and safety of the procedure (Evidence: Weak) 1.

    • References

    1 al-Faran MF, al-Omar OM. Retrobulbar alcohol injection in blind painful eyes. Annals of ophthalmology 1990. link

    Original source

    1. [1]
      Retrobulbar alcohol injection in blind painful eyes. — al-Faran MF, al-Omar OM Annals of ophthalmology (1990)
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