Worldwide, millions of retrobulbar injections are made each year to provide anesthesia for cataract surgery. No matter how carefully performed, this procedure carries an inherent risk of injury to the optic nerve. Accidental insertion of a needle into the optic nerve can have disastrous consequences, including optic nerve sheath hemorrhage, retrobulbar hemorrhage, central retinal artery occlusion, central retinal vein occlusion, Purtscher's retinopathy, or brain-stem anesthesia. These complications usually produce dramatic signs, leaving the surgeon little doubt that an injury must have occurred during retrobulbar injection. We describe a patient who experienced severe loss of vision after cataract surgery, with nothing more than an afferent pupil defect detected during the eye examamination the next day. Magnetic resonance (MR) imaging provided evidence for a traumatic injury to the optic nerve from the retrobulbar needle.
Report of a Case.
A 72-year-old woman underwent extracapsular cataract extraction with tion tion of a posterior chamber
Horton JC, Hoyt WF, Foreman DS, Cohen JA. Confirmation by Magnetic Resonance Imaging of Optic Nerve Injury After Retrobulbar Anesthesia. Arch Ophthalmol. 1996;114(3):351–353. doi:10.1001/archopht.1996.01100130347026