Intraocular Haemorrhage After Epidural Injection

Abstract

EARLY OCCLUSION IN STRABISMUS All except one patient achieved bilateral central fixation, the majority of the squints becoming alternating in type, with equal visual acuity. In over half the patients a temporary stage occurred in which the non-central fixation and the squint were transferred to the originally fixing eye. The excellence of these results is ascribed to the fact that none had had any previous treatment, the majority attending for treatment at a relatively early stage after the onset of the squint, and, perhaps even more important, to the intensive and rigorous nature of the occlusion used. I thank the surgeons of the Manchester Royal Eye Hospital for their reference of cases for study and treatment. REFERENCES

Complications of Interlaminar Cervical Epidural Steroid Injections

“…Other potential complications mentioned when discussing ICESI include retinal hemorrhage 64,65 and allergy to injectate (Table 9). 66 Arachnoiditis after lumbar injection may be due to the neurotoxic polyethylene glycol component of methylprednisolone acetate, 7,67-69 although we found no cases or studies specifically associated with ICESI.…”

Valsalva hemorrhagic retinopathy presenting as a rare cause of impaired vision after a general anesthetic—a case report and review of the literature

“…The remaining anesthesia-related VHR cases were associated with epidural injections [6,7,9,8,12]. Although some of these patients also received general anesthetics for these injections, the proposed mechanism for the hemorrhage was increased retinal venous pressure secondary to increased intracranial pressure due to displacement of cerebrospinal fluid in the spinal canal.…”

“…Valsalva hemorrhagic retinopathy has also been reported after common medical and surgical interventions including the following: colonoscopy [15], upper endoscopy [16,17], laparoscopy [4,11], laparoscopic cholecystectomy [5], prostate biopsy [50], dental procedures [18,19], lumbar and caudal epidural injection [6][7][8][9][10]12], a seizure [51], choking and an attempted Heimlich maneuver [52], and cardiopulmonary resuscitation (CPR) [53].…”

“…Postoperative visual loss may occur after common interventions and has been previously reported after a number of seemingly benign and common anesthetic-related maneuvers [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19].…”

Acute Vision Loss Secondary to Epidural Blood Patch

“…3 Iatrogenic Terson syndrome has also been described with epidural space injection. [4][5][6][7][8][9][10] Eleven cases total have been reported in the literature following lumbar spine epidural saline and steroid injection ( Table 1). Ten of those 11 were female, and full visual recovery took place in 9 of 11 patients over a time span ranging from 3 months to 3 years.…”