Causes And Treatment of Blind Painful Eyes 

Patients with unsalvageable vision and unseeing eyes may sometimes experience pain in the eyes for various reasons. A trained eye surgeon will examine the underlying causes of the pain, evaluate how mild or severe the pain may be, and provide appropriate treatments to manage the condition. 

Oculoplastic surgeon Dr. Jennifer Hui provides treatments for blind painful eyes and other conditions to patients in Palm Springs, Palm Desert, La Quinta, Coachella Valley, Riverside, Redlands, Yucaipa, Loma Linda, and surrounding communities.

Some of the common causes the ocular pain with vision loss may include:  

• Corneal decompensation and bullae, epithelial defects 
• Uveitis  
• Elevated IOP  
• Ocular ischemia  

Angle-closure glaucoma, neovascular glaucoma, bullous keratopathy, and ocular trauma are often present. The cornea may become opaque in many cases. An experienced eye surgeon will perform a detailed physical examination and review the patient’s clinical history thoroughly to understand the causes of pain and the duration of vision loss in order to determine the appropriate course of treatment.

Topical ocular antihypertensive medications can be a reasonable starting point for the treatment for blind, painful eye secondary to high IOP. Miotics are usually ineffective and could aggravate ocular irritation. When ocular ischemia or uveitis are the underlying cause of the ocular pain, topical anti-inflammatory medications such as perdnisolone acetate 1% could serve as a good adjunctive therapy (dosage: one to four times a day).  

If the patient’s eyes have corneal decompensation, it may be necessary to administer topical antibiotic steroid ointment or drops to prevent infection. Topical saline solutions may also be considered in this condition to achieve quiet eyes and ocular comfort.  

The patient with blind, painful eyes may ultimately choose to undergo enucleation or evisceration procedure. Your oculoplastic surgeon may prefer evisceration procedure for cosmetic reasons. In cases where an intraocular tumor is suspected, enucleation may be a better option. This will require a definitive diagnosis before the treatment approach is finalized.  

Enucleation and evisceration treatment options should be discussed with the patient early on to address their condition of blind, painful eyes. The eye surgeon will most likely begin with medical therapy or a laser procedure. It can provide some comfort from the pain as well as support the patient’s psychological and emotional well-being.  

However, eventually, evisceration or enucleation will prove to be the best treatment option for most patients. Patients may regain their normal appearance from a skillfully performed evisceration procedure, and may obtain permanent relief from chronic pain. With these results, the patient can achieve maximum satisfaction and a lasting resolution to their condition.   

Management of the painful, blind eye can be a challenging process. An experienced oculoplastic surgeon will adopt a step by step treatment approach, which minimizes the dependence on topical medications. If the blind, painful eye responds poorly to laser or medical therapies, and is cosmetically unattractive, evisceration or enculeation may be the best treatment options available to a patient.