Blindness Following Retrobulbar Hemorrhage after Retrobulbar Anesthesia

A 66-year-old woman who had a retrobulbar anesthesia for cataract surgery developed permanent blindness associated with a retrobulbar hemorrhage without central retinal artery occlusion or prominent optic nerve trauma. Radio images showed a unique intraconal hematoma. Retrobulbar anesthesia for cataract surgery has many complications, ranging from mild subcutaneous hemorrhage to severe retrobulbar hemorrhage with central retinal artery occlusion and/or optic nerve damage and leading to permanent blindness. Although blindness without central retinal artery occlusion or optic nerve trauma following retrobulbar hemorrhage been reported in peribulbar anesthesia for cataract surgery, (1) it had not been reported in retrobulbar anesthesia. We report a case of blindness following retrobulbar hemorrhage after retrobulbar anesthesis. Ocular fundus of the patient did not reveal any evidence of central retinal artery occlusion. Magnetic resonance imaging (MRI) showed no evident optic nerve displacement or enlargement. The possible etiologies of blindness in this case and the managements of major retrobulbar hemorrhage will be discussed.

並列關鍵字

cataract surgery ； corticosteroids ； ischemic optic neuropathy

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