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Retrobulbar haemorrhage post sub-Tenons block: a case report.
Alessandro M Costa1, Sharanjeet Sidhu2, Thomas G Hardy3,4,5
1Orbital Plastics and Lacrimal Unit, Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne, VIC, 3002, Australia. alessandromarcocosta@gmail.com.
Journal of Medical Case Reports
|December 10, 2025
Summary
Retrobulbar hemorrhage is a rare but serious complication of sub-Tenon
Area of Science:
- Ophthalmology
- Ophthalmic Surgery
Background:
- Retrobulbar hemorrhage is a rare, sight-threatening complication.
- It can lead to orbital compartment syndrome and irreversible vision loss if not treated promptly.
- Hemorrhage following sub-Tenon's block is exceptionally rare, especially in patients without bleeding risks.
Purpose of the Study:
- To report a rare case of retrobulbar hemorrhage after sub-Tenon's block.
- To emphasize the importance of prompt diagnosis and management.
- To raise awareness of this potential complication.
Main Methods:
- Case report of a 75-year-old male.
- Sub-Tenon's block administered for encysted bleb needling.
- Emergency lateral canthotomy and cantholysis performed for orbital compartment syndrome.
Main Results:
- The patient developed acute retrobulbar hemorrhage immediately post-injection.
- Symptoms included severe ocular pain, restricted eye movements, and hypertension.
- Emergency intervention successfully resolved the compartment syndrome.
Conclusions:
- Retrobulbar hemorrhage can occur even without predisposing factors.
- Vigilance for this complication after sub-Tenon's block is essential.
- Timely intervention is critical for vision preservation.
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