Severe Pain in Right Eye

For nearly two years I have had experienced severe to chronic pain in my right eye.  Over the past two years, I have seen 4 doctors, including opthamologists, optometrists, and I am currently seeing a neuro-ophthalmologist.  I have had a multitude of tests including 2 MRI's.  Recently I have been experiencing floaters when I have the pain.  The pain is becoming more frequent and more severe.  At times I also experience a sharp line of pain straight through my brain.  My orbital itself is what hurts and I do not have vision loss.  We have tried injections of lidocaine, steroids, steroid drops, oral steriods, indocin, and gabapentin; none of which have helped.  The pain is NOT a migraine. I am NOT having sinus issues or The doctor I am currently seeing is at Barnes Jewish Hospital's Center for Advanced Medicine.  We are quickly running out of options and doctors in the St. Louis area and the doctors are at a loss.

[Sandra M Brown, MD]

Research the Boston Foundation for Sight.  You may be having a variant of a condition called keratoneuralgia, and Dr. Perry Rosenthal is doing a lot of work on the problem through the BFS.  You may also have occipital neuralgia, which can be treated with a combination steroid / lidocaine injection to the occipital nerve at the base of your neck.  This should be tried if it hasn't already.  I have to tell you that the combination of vision changes (floaters) and weird pain around the eye IS STILL possibly migraine.

[missarchi]

Dr. Brown, They have already tried steroid/lidocaine injections a total of 5 times.  They say the floaters that I am experiencing are not normal or typical floaters.  I had already been seeing the Ryan Headache Center for migraines and the pain I'm experiencing with my eye is nothing even close to a migraine. We have tried various pain meds and meds for migraine relief, non of which have worked.

[missarchi]

I also meant to mention that I have been tested for dry eye and my tear production is in the normal range.  They have already ruled out trigeminal neuralgia,  keratoconjunctivitis sicca, and may other conditions and dieseases.

Thank you for your response.  Any other ideas or suggestions are greatly appreciated! :)

Thanks again!