Inadvertent ocular penetration during eyelid anesthesia – Case presentation and review of literature

We report a case of inadvertent ocular penetration during eyelid block with local anesthesia for blepharoptosis surgery. A 51-year-old female was planned for levator reattachment procedure for aponeurotic ptosis in the left eye. Following eyelid infiltration using a 30-G, 0.5-inch needle, a localized conjunctival chemosis with intraocular air bubble was noted in the anterior chamber. There was no diminution in vision, and whatever was visible in the posterior segment examination was within normal limits. The procedure was abandoned. After observation for 2 weeks, the patient was operated uneventfully under local anesthesia. Local anesthetic injection during eyelid infiltration may be complicated by inadvertent ocular penetration. Knowing thorough anatomy of the eyelid, using the appropriate technique and immediate identification of signs and symptoms of ocular penetration can prevent any further complications from happening.