Retrobulbar Block: Complications

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.