title: Intraocular pressure, retrobulbar anaesthesia and digital ocular massage.
abstract: OBJECTIVE
  To determine the degree of intraocular pressure (IOP) rise following retrobulbar anaesthetic injection as well as the optimal time required for the return of the IOP to the pre-injection level following ocular massage.
  
  
  METHODS
  Using the Perkins hand-held tonometer, the IOP of consecutive adult patients were measured in the operating room before local anaesthetic (3 ml of 2% xylocaine with or without adrenaline) injection; immediately after injection and every minute following ocular massage for the next 5 minutes.
  
  
  RESULTS
  Twenty-three eyes of 17 patients, aged 23-71 years, were studied. The mean (+/- SD) baseline (preinjection) IOP was 16.6 (+/- 6.8) mmHg. Immediately after the injection the IOP rose by 11.8-80% with a mean of 37.3 +/- 16.8% (95% CI: 30.4-44.2). By 3 minutes the IOP had returned to the pre-injection level. After 3 minutes the IOP had become lower than the pre-injection level (p < 0.05)
  
  
  CONCLUSIONS
  IOP rise following retrobulbar injection of 3 ml of local anesthetic varies from 11.8-80%. Digital ocular massage lowers the IOP to pre-injection level in 60.2% in 3 minutes; in 5 minutes it lowers the IOP to preinjection level in all eyes and to below pre-injection level 86%.
authors.affiliation: Guinness Eye Center, Onitsha Nigeria. sabenwosu@yahoo.com
authors.forename: S N N
authors.initials: SN
authors.lastname: Nwosu
authors.forename: A I
authors.initials: AI
authors.lastname: Apakama
authors.forename: B C
authors.initials: BC
authors.lastname: Ochiogu
authors.forename: C N
authors.initials: CN
authors.lastname: Umezurike
authors.forename: V O
authors.initials: VO
authors.lastname: Nwosu
mesh_terms: D000328:Adult; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects*; D008012:Lidocaine / Q000009:adverse effects*; D008297:Male; D008405:Massage; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011312:Pressure; D013997:Time Factors; D014065:Tonometry, Ocular / Q000379:methods; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine