The CT-topography of retrobulbar anesthesia. Anatomic-clinical correlation of complications and suggestion of a modified technique.

The anatomic relationship of an injection needle as traditionally placed in retrobulbar anesthesia to optic nerve, orbital vessels and eye muscles is demonstrated by computed tomography. The clinical complications of retrobulbar injections are reviewed and correlated to the orbital topography in different positions of gaze, as analyzed in anatomic sections and CT images. The results indicate that with the transitional technique of retrobulbar injection the most important orbital structures are in the immediate neighbourhood of the needle. A different injection technique is discussed.