REFERRED OCULAR PAIN RELIEVED BY SUBOCCIPITAL INJECTION

Pain originating from ophthalmic disease has been well documented. A s eries of patients presenting with eye or periorbital pain attributed t o cervical region dysfunction were diagnosed and treated with injectio ns of subcutaneous lidocaine followed by triamcinolone acetonide. Twel ve patients, 11 women and 1 man, ranging in age from 20 to 82 years ha d an evaluation including a complete eye examination, and laboratory t ests and neuroimaging as dictated by the history to exclude structural abnormalities or systemic disease. All patients had marked focal subo ccipital tenderness ipsilateral to the side of their headache and eye pain. A subcutaneous injection with 2% lidocaine followed by triamcino lone acetonide 40 mg was administered directly to the site of focal te nderness. After injection, five patients described total relief of pai n, five patients described some degree of pain relief, and two patient s had no relief of headache. Duration of pain relief ranged from sever al hours to 3 months. Patients may present with periorbital or eye pai n as a result of disease affecting the cervical sensory roots with sub sequent stimulation of the trigeminal apparatus. Subcutaneous injectio n of lidocaine and triamcinolone acetonide may be of help in the diagn osis of these patients and provide temporary relief.