To the Editor.
—I found the editorial by Moore on Acanthamoeba keratitis,1 to be an excellent review. She noted that an alcohol block is very painful and that her block consisted of a mixture of absolute alcohol and 2% lidocaine. This block produces much less discomfort if one uses 1% lidocaine ten minutes before absolute alcohol is given in the retrobulbar tissue. To assure that the alcohol is placed in exactly the location of the lidocaine, one can leave the retrobulbar needle in place. It is difficult to remove the needle from the hub of the syringe manually, but this can be accomplished without disturbing the needle location if you grip the needle with a hemostat. The retrobulbar block is very useful in many cases of eye pain caused by a variety of factors, and this method causes very little discomfort to the patient.
Way DM. Less Painful Alcohol Block. Arch Ophthalmol. 1989;107(5):636. doi:10.1001/archopht.1989.01070010654011