Enucleation of blind, painful eyes

Purpose: To determine the demographics and results of treatment in patients undergoing enucleation of blind, painful eyes. Methods: Medical records were reviewed to determine the precipitating cause , preoperative symptoms, prior therapy, and results of treatment in 58 pati ents in whom enucleation was performed to relieve ocular discomfort. Patien t perception of symptoms and treatment was assessed by a follow-up mail sur vey. Results: Forty-five percent of patients had sustained prior trauma. Ocular discomfort was attributed to phthisis (43%), elevated intraocular pressure (40%), or corneal decompensation (10%). Preoperative symptoms included ocul ar pain (91%), periocular headache (17%), tearing (26%), and ipsilateral ph otophobia (26%). Eight patients experienced contralateral photophobia. Enuc leation provided complete symptomatic relief in 54 patients (93%). Two of t he four patients with persistent discomfort experienced painful facial pare sthesias, attributed to prior retrobulbar alcohol injections. Ninety-one pe rcent of the 32 patients who completed the follow-up survey reported pain r elief after surgery, whereas 94% would recommend enucleation to others with blind, painful eyes. Conclusions: Trauma is the most common precipitating condition in patients undergoing enucleation of blind, painful eyes. These patients experience a variety of symptoms, including ocular pain, facial pain or paresthesias, te aring, and photophobia. Contralateral photophobia is not uncommon. Enucleat ion is highly effective in relieving these symptoms and should be considere d in patients unresponsive to topical therapy. Facial paresthesias in patie nts who have received prior retrobulbar alcohol injections are not relieved by enucleation.