Retrobulbar Block: Complications

Advanced, Clinical Subspecialties

Retrobulbar blocks are known to cause a variety of complications including:

  • Retrobulbar hemorrhage - this can lead to central retinal artery occlusion which can result in vision loss if not properly treated
  • Perforation of the globe - this can occur with any eye block but is most common in retrobulbar blocks; symptoms include pain, restlessness, intraocular hemorrhage, retinal detachment
  • Optic nerve injury
  • Intravascular injection or injection into nerve sheath and spread to CSF - both of these can resulting in local anesthetic systemic toxicity which can lead to respiratory depression, hypoxia, bradycardia, neurological symptoms, cardiac arrest
  • Oculocardiac reflex - reflexive bradycardia and sometimes cardiac asystole due to profound parasympathetic outflow
  • Diplopia
  • Trigeminal nerve block

Retrobulbar blocks are considered safer when a blunt needle instead of a sharp needle is used.


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Colleen McKenna, MD