Lateral to Upper Eyelid Lacrimal Neuralgia

Poorly known pain condition affecting outer eyelid and temple area. Such conditions I thought no one would care about but have had thank you’s in past so here it is.

Cuadrado, María‐Luz, et al.
Lacrimal nerve blocks for three new cases of lacrimal neuralgia.
Headache: The Journal of Head and Face Pain 57.3 (2017): 460-466.

http://onlinelibrary.wiley.com/doi/10.1111/head.12985/full

• lateral upper eyelid and/or the adjacent area of the temple pain
• 3/4 known cases no cause – one after eyelid surgery
• “tenderness on palpation of the lacrimal nerve at the superoexternal angle of the orbit”
• continuous or intermittent pain
• one stabbing, one sharp, one continuous and pressing
• one low grade 2-3/10 two 7/10
• could have associated migraines
• CBC, ESR, CRP, “immunological screening” and MRI of the brain were negative

Injection technique: –  “0.5 cc of bupivacaine 0.5% with a 30-G needle. The needle was inserted through the lateral edge of the eyebrow and was directed laterally and superiorly toward the temple.” – given subcutaneously.