Peribulbar anesthesia causing bilateral orbital hemorrhage

Abstract

Kyla Garft,1,2 Peter Burt,1,2 Benjamin Burt1,3 1Bendigo Eye Clinic, Victoria, 2Ophthalmology Education, Monash University Rural Medical School, Melbourne, 3Occuloplastics Department, Royal Victorian Eye and Ear Hospital, Victoria, Australia Abstract: We report a case of bilateral orbital hemorrhage as a complication of peribulbar anesthesia in a 78 year old man. Initially, unilateral orbital hemorrhage occurred but quickly spread to the contralateral side. Neuroophthalmological assessment revealed a proptosed tense globe with normal retinovascular findings. Visual acuity was adversely affected and this was conservatively managed with no lasting ophthalmic sequela. This patient's case was reported as it illustrates an unusual complication of bilateral spread of orbital hemorrhage secondary to peribulbar anesthesia. It highlights how early ophthalmic assessment can ensure a good visual outcome in the setting of appropriate ophthalmic monitoring. The mechanisms of orbital hemorrhage spread and appropriate management options are discussed. Keywords: ophthalmic, anesthetic, complication, cataract, retrobulbar, bleeding

Keywords

• Peribulbar anaesthesia
• haemorrhage
• orbit.