R etrobulbar hemorrhages may occur from facial trauma, orbital surgery, and peribulbar or retrobulbar injections. Although a retrobulbar hemorrhage reportedly occurs in less than 2% of retrobulbar anesthetic injections, it may result in a devastating loss of vision by compression of the circulation from mechanical tamponade, central retinal artery occlusion, or optic atrophy if not detected and...

n engl j med 369;11 nejm.org september 12, 2013 1080 anticoagulants may prevent warfarin-induced skin necrosis but cannot be recommended yet. Finally, in reply to Grzybowski and Ascaso: the use of antithrombotic agents in ocular surgery remains highly controversial. The stated bleeding rate of 3% is excessive in modern cataract surgery. This avascular procedure, which is frequently performed wi...

Retrobulbar hemorrhage, especially when associated with visual loss, is a rare but significant complication after facial bone reconstruction. In this article, two cases of retrobulbar hematoma after surgical repair of blow-out fracture are reported. In one patient, permanent loss of vision was involved, but with the other patient, we were able to prevent this by performing immediate decompressi...

INTRODUCTION We aim to describe a mechanism of vision loss following vitrectomy surgery with retrobulbar block (RBB) associated with severe vascular stasis of the optic nerve and macula in order to improve safety of local anesthesia for ophthalmic surgery. CASE PRESENTATION We report three cases of patients who underwent pars plana vitrectomy (PPV) with retrobulbar anesthesia with no retrobul...

PURPOSE To evaluate the effectiveness of subconjunctival anesthesia as compared to retrobulbar anesthesia for pain control during manual small-incision cataract surgery (MSICS) performed by third-year residents. DESIGN A randomized, controlled trial. PATIENTS AND METHODS A total of 150 patients undergoing routine cataract surgery were randomly assigned to receive either subconjunctival anes...

Necrotizing fasciitis is a rare, rapidly progressive severe bacterial soft tissue infection with a high mortality rate. While necrotizing fasciitis classically involves the trunk, groin/perineum, lower limbs, and postoperative wound sites, primary involvement of the eyelids is a rare but well known entity. We present a 33-year-old female patient who developed periocular necrotizing fasciitis af...

A 48-year-old man sustained significant left-sided facial and eye trauma after having been struck with a falling tree branch. He had a proptotic left eye with a fixed and dilated pupil, complete unilateral vision loss, and an intraocular pressure of 80 mmHg. An emergent lateral canthotomy was performed, ophthalmology was paged, and the patient was sent for computed tomography (CT). The orbital ...

Blepharoplasty is one of the most commonly performed surgeries for rejuvenation of the periorbital region. We present a case of unilateral permanent visual loss following a bilateral lower lid cosmetic blepharoplasty with fat removal. The etiology of retrobulbar hemorrhage following blepharoplasty, treatment, and recommendations to reduce the chance of this rare but serious complication are dis...