A man in his 40s underwent surgery to place a scleral buckle for retinal detachment in his left eye. Surgery was performed under retrobulbar anesthesia. During surgery, the patient complained of pain, so another retrobulbar injection was performed. As this was done, the needle was noted to have perforated the eye.1- 3 Indirect ophthalmoscopy revealed a vitreous hemorrhage and the intraocular pressure was low (Figure). Sterile air was injected into the vitreous and the scleral buckle procedure was completed. Laser retinopexy was performed 1 week later to treat the retinal holes.4 One month later, the best-corrected visual acuity was 20/25 OS.
Rizzo S, Giorni A, Savastano A. Imaging of Ocular Perforation After Retrobulbar Block. JAMA Ophthalmol. 2016;134(11):e162716. doi:10.1001/jamaophthalmol.2016.2716