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Temporary blindness caused by corneal edema after a local anesthetic injection in the eyebrow region: a case report

  • Hong, Jung Hyun (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Jo, Yeon Ji (Department of Ophthalmology, Pusan National University School of Medicine) ;
  • Kang, Taewoo (Busan Cancer Center, Pusan National University Hospital) ;
  • Park, Heeseung (Busan Cancer Center, Pusan National University Hospital) ;
  • Kim, Kyoung Eun (Busan Cancer Center, Pusan National University Hospital) ;
  • Lee, Jae Woo (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Bae, Seong Hwan (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine)
  • Received : 2022.08.09
  • Accepted : 2022.08.20
  • Published : 2022.08.20

Abstract

Plastic surgery around the eyes is usually performed under local anesthesia, using a mixture of lidocaine and epinephrine. Blindness is a rare but devastating complication after the injection of local anesthesia in this region. Most cases reported to date have been caused by occlusion of the ophthalmic artery or central retinal artery. In this case report, however, we present a highly unusual case of blindness caused by corneal edema after a local anesthetic injection. A patient visited the emergency room with a laceration on the eyebrow, and local anesthesia was injected before suturing. Immediately after the injection, severe corneal edema developed, making it impossible to observe the structures in the anterior chamber in detail or check the light reflex and visual acuity of the naked eye. An antibiotic (moxifloxacin hydrochloride) and high-concentration steroid eyedrops were promptly applied. High-concentration steroids were also administered orally. On day 13 post-injury, the visual acuity of the naked eye improved to 1.0, and no recurrence of corneal lesions was observed. Although the cause of corneal edema after the local injection could not be conclusively identified, we hope that this report will help raise clinicians' awareness of this complication and appropriate treatment methods.

Keywords

Acknowledgement

This work was supported by clinical research grant from Pusan National University Hospital in 2022.

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