A SENSORY block of the upper eyelid can be achieved without loss of extraocular muscle function or distortion of lid tissues with a single, small, properly placed injection. This technique simultaneously blocks the frontal and lacrimal nerves at their point of divergence posteriorly in the orbit. It has been used in a variety of lid procedures, but finds its greatest value in ptosis surgery where retention of ocular motility permits ideal placement of the lid margin.
Any of the usual anesthetic solutions may be used, preferably without the addition of hyaluronidase since this may permit some penetration of the anesthetic solution through the intermuscular membrane into the deeper orbital tissues. A 4-cm needle, about size 23 or 22, is introduced precisely at the midpoint of the upper lid just below the bony orbital margin. At this location, the needle is some distance lateral to the frontal nerve, reducing the
Hildreth HR, Silver B. Sensory Block of the Upper Eyelid. Arch Ophthalmol. 1967;77(2):230-231. doi:10.1001/archopht.1967.00980020232015