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Trochleitis is inflammation of the superior oblique tendon trochlea apparatus characterized by localized swelling, tenderness, and severe pain. This condition is an uncommon but treatable cause of periorbital pain. The trochlea is a ring-like apparatus of cartilage through which passes the tendon of the superior oblique muscle.
Ocular neuropathic pain, also called corneal neuralgia, is a spectrum of disorders of ocular pain which are caused by damage or disease affecting the nerves.Ocular neuropathic pain is frequently associated with damaged or dysfunctional corneal nerves, [1] but the condition can also be caused by peripheral or centralized sensitization. [2]
Surgical decompression is often considered to be the last resort. In one study of 11 patients, only two patients did not experience significant pain relief postoperatively and mean pain episodes per month decreased from 17.1 to 4.1, with mean pain intensity scores also decreasing from 7.18 to 1.73.
The pain occurs only on one side of the head, around the eye, particularly behind or above the eye, in the temple. The pain is typically greater than in other headache conditions, including migraines , and is usually described as burning, stabbing, drilling or squeezing. [ 15 ]
Major symptoms are sudden loss of vision (partial or complete), sudden blurred or "foggy" vision, and; pain on movement of the affected eye. [4] [5] [2]Many patients with optic neuritis may lose some of their color vision in the affected eye (especially red), with colors appearing subtly washed out compared to the other eye.
Spasm of accommodation is frequently resistant to treatment. However, some patients do find relief through the use of daily eye dilation with cycloplegic drops. One side effect of cycloplegic drops is that they often have BAK as a preservative ingredient, which, with daily use, can erode the tear shield: