Blindness following cosmetic blepharoplasty—a review

A case of unilateral blindness following cosmetic blepharoplasty is reported. A review of some 60 previously recorded cases is made with a more detailed analysis of 22 cases. An attempt has been made to highlight the opinions on causes and treatment held in common by those authors who have previously reported and discussed their cases. A degree of retrobulbar haemorrhage was a feature common to most cases and the final event leading to permanent visual impairment was usually ischaemia of retinal or optic nerve tissue. The relationship between these findings remains uncertain although intra-orbital compression was thought to be a frequent common pathway. Recommendations to reduce the chance of this rare but serious complication are made. The importance of simple pre-operative eye records and the early involvement of an ophthalmic surgeon when retrobulbar haemorrhage arises are stressed.