Retrobulbar hemorrhage after 12,500 retrobulbar blocks

To determine the incidence of hemorrhage after retrobulbar nerve block, 12,500 consecutive cases were reviewed. Fifty-five retrobulbar hemorrhages occurred after retrobulbar injection, a prevalence of 1 in 227 (0.44%). This compares favorably with the quoted prevalence of 1%-3% in the literature. Acquired vascular disease was a significant risk factor (P < 0.017). Surgery was postponed in 41 (75%) of the cases in which a hemorrhage developed. Although retrobulbar hemorrhage is considered a serious complication of retrobulbar anesthesia, the eventual visual outcome after surgery in these patients was not significantly different from the control group.