Sight-threatening acute orbital swelling from peribulbar local anesthesia

Area of Science:

• Ophthalmology
• Anesthesiology
• Allergy and Immunology

Background:

• Peribulbar anesthesia is a common procedure for ophthalmic surgeries.
• Severe allergic reactions to local anesthetics used in peribulbar injections are exceptionally rare.

Observation:

• A 70-year-old female patient developed acute orbital swelling and optic nerve dysfunction post-peribulbar injection.
• The patient's symptoms indicated a severe adverse reaction to the anesthetic agent.

Findings:

• The patient was diagnosed with a probable allergy to lignocaine, a common local anesthetic.
• Treatment involved acute orbital decompression, intravenous antibiotics, and methylprednisolone.

Implications:

• Early recognition and intervention are critical for managing such rare allergic reactions.
• Prompt treatment can avert potentially severe and permanent visual consequences in patients.