Inadvertent intraocular injection of methylprednisolone in a patient with prior superior oblique tuck surgery

Abstract

Summary Background To report inadvertent intraocular methylprednisolone injection into an eye that had previously undergone superior oblique tuck surgery. Material and methods An observational case report. Results An inadvertent intraocular penetration occurred following periorbital methylprednisolone injection, which was performed via the superonasal quadrant to relieve trochlear pain in an eye that had undergone previous superior oblique tuck procedure. There was immediate loss of vision, afferent pupillary defect, and raised intraocular pressure. Fundoscopy revealed intravitreal and subretinal methylprednisolone with retinal detachment. Immediate removal of intravitreal and subretinal methylprednisolone was performed with a retinal reattachment procedure. Postoperatively, retinal necrosis was noted in the area that was in contact with methylprednisolone. Conclusions This case highlights the risk of inadvertent intraocular penetration while injecting through a limited periorbital space that has been previously operated on.