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Painful Eye Caused by Neoplasm: A Case Report and Review
Michelle Ouellette1, Jorge Agi2, Matthew Murphy1
1Department of Supportive Care Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
Journal of Palliative Medicine
|December 30, 2025
Summary
Severe eye pain from basal cell carcinoma invading the orbit is challenging. Palliative enucleation (eyeball removal) effectively resolved pain in a patient with this rare condition.
Area of Science:
- Ophthalmology
- Oncology
- Pain Management
Background:
- Ocular discomfort is a common side effect of cancer treatments.
- While dry eye is manageable with lubricants, severe eye pain from tumors is challenging.
- Basal cell carcinoma with orbital invasion is an uncommon cause of significant eye pain.
Purpose of the Study:
- To present a case of basal cell carcinoma with orbital invasion causing severe eye pain.
- To review the nociceptive pathway of the eye.
- To highlight palliative enucleation as a treatment option for intractable eye pain due to orbital tumors.
Main Methods:
- Case report of a 63-year-old male with basal cell carcinoma and orbital invasion.
- Description of escalating analgesic regimens.
- Ocular oncology referral and subsequent enucleation (surgical removal of the eyeball and optic nerve).
Main Results:
- The patient experienced persistent, severe eye pain unresponsive to increased analgesics.
- Surgical enucleation resulted in complete resolution of the patient's eye pain.
- Histopathological confirmation of basal cell carcinoma with orbital invasion.
Conclusions:
- Atypical basal cell carcinoma with orbital invasion can cause severe, intractable eye pain.
- Palliative enucleation is a viable and effective treatment for refractory eye pain in such cases.
- Understanding ocular pain pathways is crucial for managing complex oncological conditions affecting the eye.
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