Korean J Pain.  2009 Dec;22(3):241-244. 10.3344/kjp.2009.22.3.241.

Retrobulbar Hematoma after Infraorbital Nerve Block in Trigeminal Neuralgia: A case report

• Park JT
• Kim YW
• Jeong EK
• Lee YB

• KMID: 1978700
• DOI: http://doi.org/10.3344/kjp.2009.22.3.241

Abstract

Retrobulbar hematoma can arise from orbital trauma and periorbital or intraorbital procedures, and it can result in several morbidities including vision loss. Making the immediate diagnosis and performing decompression of the retrobulbar hematoma are crucial for preventing serious morbidities such as permanent vision loss. We present here a case of temporary vision loss that was due to iatrogenic retrobulbar hematoma in a patient who received infraorbital nerve block for the treatment of trigeminal neuralgia. A 70-year-old woman with trigeminal neuralgia was treated with infraorbital nerve block. Just after the procedure she experienced acute periorbital swelling, proptosis and worsening visual acuity. Immediate orbital computed tomography was done, and this revealed a retrobulbar hematoma. The patient underwent lateral canthotomy with cantholysis and administration of dexamethasone and mannitol. Improvement of visual acuity began 3 hours after these procedures. Her visual acuity was greatly improved 12 days after admission.

Keyword

infraorbital nerve block; retrobulbar hematoma

MeSH Terms

Aged
Decompression
Dexamethasone
Exophthalmos
Female
Hematoma
Humans
Mannitol
Nerve Block
Orbit
Trigeminal Neuralgia
Vision, Ocular
Visual Acuity
Dexamethasone
Mannitol