Painful Eye Caused by Neoplasm: A Case Report and Review

Ocular discomfort due to cancer treatments is common and typically treated with supportive care. For example, dry eye caused by some chemotherapies is managed with ocular lubricants. However, managing severe eye pain caused by tumor is challenging. We describe the case of a 63-year-old man with eye pain caused by basal cell carcinoma of the face with orbital invasion-an uncommon finding. Severe eye pain persisted, despite escalation of the patient's analgesic regimen. He was referred to an ocular oncologist by his palliative care physician and underwent surgical removal of the left eyeball and optic nerve (enucleation) with complete resolution of pain. We present this case to highlight an atypical case of basal cell carcinoma with orbital invasion as a cause of severe eye pain, to provide an overview of the nociceptive pathway of the eye, and to highlight palliative enucleation as a potential treatment option for similar cases.