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Contralateral amaurosis after retrobulbar injection.

H L Friedberg, O R Kline

    American Journal of Ophthalmology
    |June 15, 1986
    PubMed
    Summary
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    Transient blindness after retrobulbar injection can occur due to anesthetic migration. A modified technique, altering eye positioning, prevents optic nerve sheath puncture and subarachnoid injection, preserving vision.

    Area of Science:

    • Ophthalmology
    • Anesthesiology

    Background:

    • Retrobulbar injections are common for ophthalmic procedures.
    • Complications can include unintended anesthetic spread.

    Observation:

    • Two patients experienced contralateral amaurosis post-retrobulbar injection.
    • Amaurosis was attributed to anesthetic migration to the optic chiasm and nerve via the subarachnoid space.

    Findings:

    • Visual acuity returned to baseline within 90 minutes in both cases.
    • A modified retrobulbar injection technique, with the patient looking straight ahead or downward/outward, was effective.

    Implications:

    • This modified technique may prevent optic nerve sheath perforation and subarachnoid injection.
    • Altering globe positioning during retrobulbar anesthesia can enhance patient safety and visual outcomes.

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