Abstract
BackgroundTrigeminal neuralgia is a rare cause of postoperative pain after ophthalmic surgery and has only been described twice in the international literature: one case of pain after vitrectomy with a crystalline lens extraction and another case of an unspecified surgery type. We report three cases of ophthalmic surgery-induced trigeminal neuralgia.Case presentationTrigeminal neuralgia was diagnosed in three patients after ophthalmic surgery. Patient 1 was a 63-year-old Caucasian man with an epiretinal membrane and cataract in his left eye. Phacovitrectomy was performed. Patient 2 was a 38-year-old Caucasian man with a perforating wound in his right eye. Primary closure of the cornea with removal of the necrotic iris was performed. Patient 3 was a 52-year-old Caucasian man referred 15 days after suffering blunt trauma to his right eye. Vitrectomy was performed to remove the crystalline lens, which was luxated to the vitreous. On postoperative days, these three patients were admitted to an emergency ward due to sudden, shock-like, one-sided facial pain activated by numerous stimuli. After consultation with specialists from the anesthesia and neurology departments, a diagnosis of trigeminal neuralgia was made. This diagnosis was based on the presence of four of the nine clinical criteria described by the International Headache Society, which were met in these three cases.ConclusionsTrigeminal neuralgia is a rare cause of postoperative ophthalmic pain and is a challenging diagnosis for the ophthalmologist. It is necessary to consider the differential diagnosis of atypical pain after ophthalmic surgery.
Highlights
Trigeminal neuralgia is a rare cause of postoperative pain after ophthalmic surgery and has only been described twice in the international literature: one case of pain after vitrectomy with a crystalline lens extraction and another case of an unspecified surgery type
Trigeminal neuralgia is a rare cause of postoperative ophthalmic pain and is a challenging diagnosis for the ophthalmologist
It is necessary to consider the differential diagnosis of atypical pain after ophthalmic surgery
Summary
Trigeminal neuralgia (TN) is a pain disorder affecting the fifth cranial nerve (trigeminal nerve) and is characterized by severe, paroxysmal, lancinating facial pain, especially in areas where some branches of the nerve are distributed. Case 1 A 63-year-old Caucasian man, a dentist, was referred by another professional with an epiretinal membrane and cataract in his left eye His medical history revealed he had hypertension for the past 6 years under treatment. Case 2 A 38-year-old Caucasian man, a mechanic, presented at the Ophthalmology unit of Sanatorio Mapaci with a perforating wound in his right eye He had no relevant past medical/family history or eye problems. On postoperative day 1 he did not experience pain and his visual acuity was light projection; IOP was 6 mmHg. The corneal wound was sealed with seven stitches (10/00 nylon sutures), Seidel test was negative, and hyphema was grade IV. Case 3 A 52-year-old Caucasian man, a construction worker, was referred 15 days after suffering a blunt trauma to his right eye His visual acuity was no light perception.
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