DR. PRATIKSHA MALI

DR.RISHI M MEHTA

Abstract

A 60 years old female patient presented with gradually progressive painful loss of vision in LE since 4 years, not relieved by oral analgesics and antiglaucoma medications. BCVA in RE was 6/12 and LE was PL negative. IOP (in mm Hg) in RE and LE was 20 and 47 respectively. Slit lamp examination showed LE conjunctival congestion, severe corneal oedema, shallow anterior chamber, rubeosis iridis and fixed pupil. Lens and fundus details were not visible due to corneal oedema. RE was normal. Cyclocryotherapy was performed in LE which did not relieve her severe pain. 2 weeks later, retrobulbar injection of 2% xylocaine followed by 2ml of absolute alcohol (99%) was given after informed consent. Pain was relieved by next day but she developed lid oedema, blepharoptosis and external ophthalmoplegia. Retrobulbar injection of alcohol is a rarely used technique due to its associated complications but very helpful for patients of painful absolute glaucoma not responding to conventional treatment.