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June 1993

Topical Anesthesia in a Patient With a History of Retrobulbar Hemorrhage

Author Affiliations

Bakersfield, Calif

Arch Ophthalmol. 1993;111(6):733. doi:10.1001/archopht.1993.01090060019007

Retrobulbar and peribulbar anesthesia are the most widely used and accepted means of providing local anesthesia during cataract surgery. These techniques are generally safe and effective; however, serious complications can be associated with them. Topical anesthesia eliminates these risks.

Report of a Case.  —A 78-year-old white woman with no history of bleeding disorders experienced a retrobulbar hemorrhage in the right eye during cataract surgery. The surgery was immediately stopped, and the hemorrhage was appropriately managed with no apparent permanent sequelae. The patient was taking no anticoagulants or medications with antiplatelet activity.The following day, the patient sought a second opinion. The patient's best corrected visual acuity was 20/60 OD. The pupillary examination findings were normal. The right eye was not proptotic. There was marked periorbital ecchymosis, 360° subconjunctival hemorrhage, and a nuclear sclerotic cataract in the right eye. A dilated funduscopic examination of the right eye was unremarkable. A hematologic

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