Plastic surgery around the eyes is usually performed under
local anesthesia, using a mixture of
lidocaine and
epinephrine.
Blindness is a rare but devastating complication after the injection of
local anesthesia in this region. Most cases reported to date have been caused by occlusion of the ophthalmic artery or central retinal artery. In this case report, however, we present a highly unusual case of
blindness caused by
corneal edema after a
local anesthetic injection. A patient visited the emergency room with a
laceration on the eyebrow, and
local anesthesia was injected before suturing. Immediately after the injection, severe
corneal edema developed, making it impossible to observe the structures in the anterior chamber in detail or check the light reflex and visual acuity of the naked eye. An
antibiotic (
moxifloxacin hydrochloride) and high-concentration
steroid eyedrops were promptly applied. High-concentration
steroids were also administered orally. On day 13 post-injury, the visual acuity of the naked eye improved to 1.0, and no recurrence of corneal lesions was observed. Although the cause of
corneal edema after the local injection could not be conclusively identified, we hope that this report will help raise clinicians' awareness of this complication and appropriate treatment methods.