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Visual loss following intranasal anesthetic injection
P J Savino1, R M Burde, R P Mills
1Neuro-Ophthalmology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107.
Journal of Clinical Neuro-Ophthalmology
|June 1, 1990
Summary
Nasal surgery can lead to vision loss due to vasospasm. Submucosal anesthetic injections with epinephrine are suspected causes of these serious visual complications.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
Background:
- Nasal surgeries carry potential risks.
- Ocular complications following nasal procedures are rare but significant.
Observation:
- Four patients experienced visual loss post-nasal surgery.
- Specific diagnoses included branch retinal artery occlusion, central retinal artery occlusion, anterior ischemic optic neuropathy, and posterior ischemic optic neuropathy.
Findings:
- The primary suspected mechanism for visual loss is vasospasm.
- High-pressure submucosal injection of local anesthetic containing epinephrine is implicated as the causative factor.
Implications:
- This highlights a critical risk associated with specific anesthetic techniques in nasal surgery.
- Ophthalmologists and ENTs should be aware of this potential iatrogenic complication.
- Further research into anesthetic protocols and vasospasm prevention is warranted.