Tranient impaired viion, external ophthalmoplegia, and internal ophthalmoplegia after blepharoplaty under local anetheia

Purpoe To report a cae of tranient bilateral viion impairment with external ophthalmoplegia and internal ophthalmoplegia after blepharoplaty under local anetheia. Deign Interventional cae report Method A 70-year-old man underwent bilateral upper blepharoplaty under local anetheia. During orbital fat removal additional anethetic wa injected into both medial fat pad for pain control. Reult Immediate potoperative examination revealed bilateral decreaed viual acuity and internal ophthalmoplegia in the right eye. An exotropia wa preent with marked limitation of right eye adduction. Thee finding reolved completely 3 hour potoperatively. Concluion Local anetheia during blepharoplaty can enervate the optic nerve, ciliary ganglion, and extraocular mucle nerve. Local anetheia hould be injected judiciouly during orbital fat removal to avoid thi reverible but alarming event