Background: Trigeminal neuralgia (TGN) is a challenging pain syndrome.

Objective: To test the effectiveness of local instillation of ophthalmic solution of amethocaine in relieving the pain of TGN.

Methods: We performed an open-label prospective study in 40 consecutive currently treated patients suffering from TGN with a reported visual analog scale (VAS) >8 (severe pain). The patients received two drops of amethocaine 1% instilled on the cornea ipsilateral to the painful side. Pain score assessment using VAS was recorded pre- and post-treatment.

Results: A total of 32 (80%) patients reported a significant reduction in pain 10 minutes after drops instillation as compared with pre-treatment pain score. Pre-treatment VAS score was 8.53 ± 0.6 as compared with 4.78 ± 1.83 post-amethocaine treatments (P < 0.00001).

Conclusions: Topical ophthalmic instillation of amethocaine 1% can be considered as an immediate effective method for pain paroxysm of TGN.