Symptomatic lacrimal neuralgia after ophthalmic surgery

Lacrimal neuralgia has only recently been described in 3 cases. None of them had an underlying lesion or any precipitating event, so they were considered primary. Here, we report a symptomatic case due to surgical trauma.

A 73-year-old woman started having a circumscribed pain at age 66 after left cataract surgery. The pain was located in a small area of her left temple next to the lateral canthus. Pain attacks lasted 1-2 minutes, and were associated with allodynia. The attacks were precipitated by light touch on the eyelid or the temple, and were also evoked by palpation of the superoexternal angle of the orbit. An anesthetic blockade performed at the emergence of the lacrimal nerve resulted in complete and long-lasting pain relief.

Lacrimal neuralgia may be due to local trauma. This new case not only reinforces the existence of a specific neuralgia of the lacrimal nerve, but also introduces a classification into primary and secondary forms based on the etiology.