Peribulbar tramadol, clonidine, and ropivacaine in blind and seeing painful eyes

PURPOSE. To report on the treatment of painful eyes by peribulbar injection of tramadol, clonidine, and ropivacaine. METHODS. The authors treated a 72-year-old woman with chronic prephthisical pain in the left eye secondary to graft rejection after penetrating keratoplasty and an 81-year-old woman with severe ocular pain in her left eye for neovascular glaucoma secondary to an ischemic central vein occlusion. They were treated with a medial canthus injection of tramadol (100 mg/2 mL ampules), clonidine (0.15 mg/1 mL ampules), and 1% ropivacaine. RESULTS. Both injections were very well tolerated and neither transient nor lasting complications were reported. Complete pain relief was obtained in both patients within 1 day and was maintained throughout the follow-up (11 months and 7 months). CONCLUSIONS. Peribulbar tramadol, clonidine, and ropivacaine injection may represent a safe and effective treatment modality in the management of chronic ocular pain.