Retrobulbar phenol injection in blind painful eyes

Retrobulbar phenol injection was used as a neurolytic to manage blind chronically painful eyes in ten patients. The cause of the blind painful eye was absolute glaucoma in eight of the ten eyes. We used 1.5mL of 1:15 (6.7%) aqueous phenol solution in each case. None of the patients experienced any pain from the injection. Seven patients obtained complete pain relief after the procedure, and one patient had some improvement. We found a range of duration of pain relief of 4.5 to 48 months (mean, 15 months), which compares favorably with retrobulbar alcohol injection. We believe retrobulbar phenol injection is preferable to alcohol. It has the advantage of being less painful during injection because of its local anesthetic properties.