Author Affiliations: Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, Scotland (Dr Lim); Department of Anaesthesia, Lutheran Hospital, Ft Wayne, Indiana (Dr Somerville); and Indiana University School of Medicine, Ft Wayne (Dr Walker).
We appreciate El-Annan and Barr's interest in our article1 and the points they make regarding venous embolism during air/fluid exchange. Referring to the first case from our original article, a child sustained an intraocular foreign body injury with the optic nerve impaled. To avoid hemorrhage during air/fluid exchange, the intraocular pressure was at one point raised to 88 mm Hg. The patient's condition deteriorated, consistent with VAE, and the temporal association and clinical presentation indicate the air infusion as a likely cause.2
Lim LT, Somerville GM, Walker JD. Does Venous Air Embolism Occur During Air/Fluid Exchange?—Reply. Arch Ophthalmol. 2011;129(9):1244-1245. doi:10.1001/archophthalmol.2011.238