Oculocardiac reflex elicited during debridement of an empty orbit.

The oculocardiac reflex (OCR) is a well–described cardiac depressor reflex that may result in significant cardiac rate or rhythm changes, sinus and junctional bradycardia, heart block or asystole. It is also known by the eponym Aschner-Dagnini Reflex, being independently reported in 1908 by both Guiseppe Dagnini and later Bernard Aschner.1,2 The OCR is classically depicted as being precipitated by traction on the extraocular muscles or pressure on the globe. The ophthalmic branch of the trigeminal nerve serves as the afferent pathway and the vagus nerve as the efferent pathway. We report the OCR resulting in episodes of profound bradycardia and brief asystole during manipulation within a previously enucleated empty orbit. CASE REPORT