title: Posterior segment injury developed after injection of anesthetics on eyelids with needleless jet injection device.
abstract: BACKGROUND
  Though a needleless jet injection device (NJI device) has advantages over a conventional needle attached syringe for injecting anesthetics, safety of using it for lid surgery is not proved. We report a case of posterior segment injury suspected caused by a NJI device.
  
  
  METHODS
  A 47-year-old woman presented with decreased visual acuity after regional anesthesia at the lower eyelids with a NJI device.
  
  
  RESULTS
  Vitreous and subretinal hemorrhage was found associated with retinal edema adjacent to the optic disc of the right eye and around the inferior temporal arcade of the left eye. Fluorescein angiography revealed choroidal rupture in the both eyes. By 2 months, although the hemorrhage resolved, subretinal fibrosis and chorioretinal atrophy developed. Her vision decreased to 20/60 in the right eye and 20/40 in the left eye.
  
  
  CONCLUSIONS
  The energy generated by the NJI device seemed to have reached the eyeballs to cause the blunt-typed posterior segment injuries. As choroidal rupture may result in a permanent visual loss, the risks associated the off-labeled use of the device for lid surgeries should be awakened.
authors.affiliation: Department of Ophthalmology, College of Medicine, Pusan National University, 1-10, Ami-dong, Seo-gu, Busan, 602-739, South Korea.
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Lee
authors.forename: Hee Young
authors.initials: HY
authors.lastname: Choi
authors.forename: Jong Soo
authors.initials: JS
authors.lastname: Lee
authors.forename: Boo Sup
authors.initials: BS
authors.lastname: Oum
mesh_terms: D000772:Anesthesia, Local / Q000295:instrumentation*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002829:Choroid / Q000293:injuries*; D005131:Eye Injuries / Q000175:diagnosis / Q000209:etiology*; D005143:Eyelids / Q000187:drug effects; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007277:Injections, Jet / Q000009:adverse effects*; D008875:Middle Aged; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000209:etiology; D012421:Rupture; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology; D014823:Vitreous Hemorrhage / Q000175:diagnosis / Q000209:etiology; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000209:etiology*
chemical_list: D000779:Anesthetics, Local