Retrobulbar Alcohol Block for a Blind and Painful eye

There are a number of solutions for a blind and painful eye. None of these solutions will return vision to the patient but some will render the patient pain free temporarily or permanently.

Initially 1 to 4 mL of lidocaine hydrochloride 2{60df113cd5a1cd00914727638812fb5300a840b86aa020a6e915251c64286fee} (with or without epinephrine 1:100,000) is administered into the retrobulbar space by the inferotemporal standard retrobulbar technique and location . Holding the same needle in place, either 1 mL of ethyl alcohol 50{60df113cd5a1cd00914727638812fb5300a840b86aa020a6e915251c64286fee} to 100{60df113cd5a1cd00914727638812fb5300a840b86aa020a6e915251c64286fee} or chlorpromazine 25 mg/mL is then injected into the same retrobulbar space using a 1- to 3-mL syringe. Retrobulbar alcohol injections generally control pain for 3 to 6 months. Retrobulbar chlorpromazine can control pain for a year or more.

It is important to advise the patient that the effect is temporary and generally associated with significant swelling of the eyelid, strabismus, and /or postoperative ptosis. The needle used can be an Atkinson or 26 gage 1.5 inch hypodermic needle. The block can be placed inferotemporal and or superonasal or both.