title: Severe visual loss caused by ocular perforation during chalazion removal.
abstract: OBJECTIVE
  To report two cases of ocular perforation during chalazion removal procedures leading to severe vision loss.
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  Two patients presented with unilateral decreased vision after chalazion removal procedures. Complete ophthalmologic examinations were performed.
  
  
  RESULTS
  Examination revealed a cherry red spot and perforation site in the first patient. In the second patient, there was an intraocular gas bubble and ischemic retina.
  
  
  CONCLUSIONS
  Local anesthetic injections for procedures such as chalazia removal can result in ocular perforation. We postulate that the intraocular injections led to extremely high pressures, compromising the blood supply to the retina and optic nerve. Anesthetic injections for all procedures, even chalazia removal, should be done with great caution. It is imperative to avoid injection if ocular perforation is suspected, as the high pressure may cause the majority of the visual morbidity.
authors.affiliation: Department of Ophthalmology, Jules Stein Eye Institute, UCLA Geffen School of Medicine, Los Angeles, California 90095, USA.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Shiramizu
authors.forename: Allan E
authors.initials: AE
authors.lastname: Kreiger
authors.forename: Colin A
authors.initials: CA
authors.lastname: McCannel
mesh_terms: D000293:Adolescent; D000779:Anesthetics, Local / Q000009:adverse effects*; D001766:Blindness / Q000209:etiology*; D017043:Chalazion / Q000601:surgery*; D015807:Eye Injuries, Penetrating / Q000209:etiology; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects*; D008875:Middle Aged; D016602:Needlestick Injuries / Q000209:etiology*; D012160:Retina / Q000293:injuries*; D012167:Retinal Perforations / Q000209:etiology*; D012590:Sclera / Q000293:injuries; D014823:Vitreous Hemorrhage / Q000209:etiology
chemical_list: D000779:Anesthetics, Local