PROPARACAINE EYE DROPS
Alternative Treatments for Facial
References | Personal Experiences | Personal
Anesthetic Eye Drops
Anesthetic eye drops (specifically Proparacaine) are reported to have been used to give
short-term relief from some cases of TN pain. Proparacaine is a local anesthetic, which
anesthetizes the eye and possibly the nerves around it. It is thus in theory possible that
it may provide some short-term relief for some cases of TN, particularly those in which
one of the upper two
branches is affected.
A newer study suggests that the
treatment is almost certainly ineffective for classical TN pain. Although otherwise
relatively harmless, Proparacaine may damage the eye if used extensively, so that it
cannot be considered a long-term treatment. The possibility is included here mainly for
completeness and for curiosity value. In addition, we do not know whether anesthetic
eyedrops have been tried in the treatment of atypical forms of TN.
This information is extracted from a paper in the J.Neurosurg Volume 77/ July 1992. Two
drops of an eye anesthetic agent (0.5% proparacaine hydrochloride) instilled for
ophthamological examination prior to cataract removal yeilded lasting relief of symptoms
of trigeminal neuralgia. This relief is belived to be best on V1 division of the
trigeminal nerve. V1 is the section of the nerve that has triggers in the upper face. They
report that 15 out of 25 patients were helped.
[Zavon and Fichte, 1991] discovered the possibility of using eye anesthetics by accident.
One of them (Zavon), himself suffering from TN, found that his TN pain vanished for over a
year immediately after an eye anesthetic was applied. The doctors then tested the
anesthetic on another TN patient, and obtained pain relief for over a month. Since this
was only a case study, no general conclusions can be drawn. [Flach, 1991] noted with
regard to the original study that repeated use of eye anesthetics may cause toxic
keratopathy, and may also slow down the healing of eye wounds. Eye anesthetics must
therefore be used with great care, if they are tried.
At least one double-blind placebo-controlled study has been made (Kondziolka et al, 1994),
and that study found that a single application of an eyedrop anesthetic does not cause any
statistically significant pain relief in the case of classical TN.
- Flach A.J. Trigeminal neuralgia relieved
by optical anesthesia. JAMA 1991 Sep 25;266(12):1649
- Kondziolka D, Lemley T, Kestle JR,
Lunsford LD, Fromm GH, Jannetta PJ. The effect of single-application topical ophthalmic
anesthesia in patients with trigeminal neuralgia. A randomized double-blind
placebo-controlled trial. J Neurosurg 1994 Jun;80(6):993-7
- Zavon MR, Fichte CM. Trigeminal
neuralgia relieved by ophthalmic anesthetic. JAMA 1991 Jun 5;265(21):2807
"I used the Proparacaine HCI solution .5%, two drops, twice a day (sometimes
3x) for almost a year---with GREAT success. Within a few minutes of putting the drops in
my eye, I could taste them in my mouth, so I could see how they might get to the nerve and
affect it also. It didn't keep the TN completely at bay, but sure did a number on the bad
stuff ! When I brought it up at the conference, I was asked if I was aware that what I had
been taking was an overdose?? It may have been---but if it was, I didn't know about it ..
My GP gave me a perscription (these drops have to be kept refrigerated )--he said,
whatever might work..... " - anonymous
this section contains purely personal and subjective opinions by individual members of
the FNR team. This section must not be considered advice).
"The fact that eyedrops seem to
work no better than a placebo may simply illustrate the power of the placebo effect. On
the other hand, the fact that some people have reported relief may mean that the treatment
is not entirely worthless. In particular, a patient with difficult atypical pain would
probably have very little to lose by trying this out." (Jakke Mäkelä)