Review Articles *Assistant Professor of Anesthesiology †Medical Director Address correspondence to Dr. Shireen Ah- mad at the Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 East Huron St., F5-704, Chi- cago, IL, USA. E-mail: sah704@ northwestern.edu Received for publication September 3, 2002; revised manuscript accepted for publication January 14, 2003. Complications of Ophthalmologic Nerve Blocks: A Review Shireen Ahmad, MD,* Afzal Ahmad, MD† Department of Anesthesiology, Northwestern University Feinberg School of Medi- cine, Chicago, IL; and Midwest Eye Center, Calumet City, IL Complications of ophthalmologic nerve blocks are rare, but they can have serious life- and sight-threatening consequences. Knowledge of the potential complications is essential for the anesthesiologist who performs ophthalmologic nerve blocks. However, most anesthesiologists are unfamiliar with these complications because the majority have been reported in the ophthalmology literature. We review the complications that may occur during the placement of ophthalmologic blocks and their appropriate prompt treatment. © 2003 by Elsevier Inc. Keywords: Anesthesia; ophthalmologic; eye surgery; ophthalmologic nerve blocks. Introduction More than one million ophthalmologic nerve blocks are performed each year in the United States. Traditionally these blocks were done by ophthalmologists, but over the last decade anesthesiologists have started performing an increasing number of these procedures. The majority of academic programs do not have a formal program to teach these nerve blocks but there is ample description of the techniques in the literature. 1–7 Complications are rare but can have serious consequences. A prior knowledge of the possible complications of the proce- dure, together with a thorough knowledge of orbital anatomy, will lead the anesthesiologist to exert care to avoid them. 8 The ability to recognize the complication and provide suitable therapy promptly can be life-saving and sight-saving. Unfortunately, most anesthesiologists are unaware of these compli- cations because the majority are documented only in the ophthalmologic literature. The complications of ophthalmologic nerve blocks fall into the following two major categories: A. Life-Threatening Brain stem anesthesia Seizures Cranial nerve block Journal of Clinical Anesthesia 15:564-569, 2003 © 2003 Elsevier Inc. All rights reserved. 0952-8180/03/$–see front matter 360 Park Avenue, South, New York, NY 10010 doi:10.1016/j.jclinane.2003.01.003