Transient Visual Loss after Retrobulbar Anesthesia in the Advanced Glaucoma Patients

ABSTRACT

Retrobulbar Anesthesia is injecting local anesthetics into the retrobulbar space within the muscle cone, which affects the third cranial nerve, ciliary ganglion and optic nerve. Proper retrobulbar anesthesia can temporarily weaken somatosensory, motor and visual sensory. It also narrows visual fields. However, it does not result in complete loss of visual acuity. According to the authors, all 4 advanced cases which showed transient and complete visual loss after retrobulbar anesthesia of Lidocaine Hcl[2% lidocaine, einephrine, 1100,000] were advanced glaucoma patients who had normal fundus except glaucomatous change and self-recovered within 1 to 4 hours. The decrease in vision may be related to the effects of the anesthetic agent on the optic nerve, or it may be related to the relative ischemia produced by compression, or caused by entopsias induced by compression. The authors cases suggest that transient visual loss after retrobulbar anesthesia may not reduce postoperative visual acuity and visual fields in the advanced glucoma patients.