The Use of Anesthetics, Steroids, Non-Steroidals, and Central-Acting Analgesics in the Management of Ocular Pain

Lorne Yudcovitch, OD, MS, FAAO

COPE #22746-OP

Expires August 1, 2011

3 credits, $59

Section: Systemic Medications

Introduction:

It is not uncommon for the optometrist to have patients presenting to the office with complaint of eye pain.  Many ocular conditions can present with varying amounts of pain (Table 1).  Pain is highly subjective, and is dependent on the type and severity of ocular insult, the chronicity of the pain symptom, and the experiential and psychological background of the patient.  As pain is subjective, the amount of pain for the same ocular insult can vary widely from patient to patient.  For example, some patients may not express any pain for a corneal abrasion, while others may relay excruciating pain for a similar injury.  Often a scale of 0 to 10 is asked by the optometrist to help them understand the amount of pain their patient is experiencing (Figure 1).  Elucidating if the pain is “burning”, “stinging”, “sharp”, “dull”, “itching”, “throbbing”, may be of diagnostic use.  Likewise, localizing if the pain is on the surface (i.e. the patient notices it with each blink) versus deeper (i.e. the patient feels a retrobulbar pain on eye movements) is also important diagnostically.

 

Figure 10.  Subconjunctival hemorrhage secondary to aspirin treatment

 

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