Retinal vascular occlusion and vascular bed injury are rare but serious complications after eye and periocular surgery. History of cardiovascular disease, retrobulbar injection, perioperative high intraocular pressure and drug toxicity have been reported as possible causative factors. Intracameral antibiotic administration during cataract surgery has been adopted by almost all ophthalmologists in the world and has been routinely applied. Intravitreal antimicrobial administration has advanced the treatment of intraocular infections. Being able to bypass the blood-ocular barriers allows high drug concentrations to be delivered directly to the posterior segment with minimal systemic absorption. However, intravitreal therapy may be associated with risks of ocular toxicity, as the difference between therapeutic and toxic doses of some antimicrobial drugs falls within a narrow concentration range.