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October 1993

Orbital Cellulitis After Retrobulbar Injection of Chlorpromazine

Author Affiliations

Tampa, Fla

Arch Ophthalmol. 1993;111(10):1322. doi:10.1001/archopht.1993.01090100028015

The retrobulbar injection of chlorpromazine hydrochloride is used by some physicians in Europe and the United States for the relief of pain in persons with irreversible blindness. In 1980, Fiore and associates1 reported that retrobulbar chlorpromazine (25 mg) was more effective in relieving pain than retrobulbar alcohol and causes fewer complications. A recent prospective, noncontrolled study confirmed these findings, demonstrating the successful relief of pain in more than 80% of 50 patients given a single retrobulbar injection of 25 mg of chlorpromazine.2 Transient hypotension occurred in a few patients but resolved within 6 hours.2 We describe herein a man who developed a sterile orbital cellulitis following retrobular injection of chlorpromazine associated with histologic evidence of fat necrosis.

Report of a Case.  A 68-year-old man was scheduled for enucleation of a blind, painful eye due to a traumatic injury sustained during World War II. The patient was offered