Trochleaectomy: An Effective Treatment of Trochlear Pain in Monocular Patients

Two distinct entities may produce trochlear pain. Primary trochlear headache is a primary headache disorder causing periocular pain that is worsened with eye movement or palpation of the ipsilateral trochlea. Trochleitis is an inflammatory condition that may be idiopathic or associated with orbital or systemic inflammatory disorders. Patients with trochleitis may improve with system anti-inflammatory medications and an injection of local anesthetic and corticosteroid is used to treat both conditions. Local injections often afford only transient relief, requiring frequent return visits for treatment. We encountered three patients with chronic trochlear pain who were functionally monocular and desired a durable treatment for their pain.