Operative Ophthalmology

·         Van Lint’s block: Terminal branches of facial nerve are blocked by injecting 2.5 ml of anaesthetic solution in deeper tissues just above the eyebrows and just below the inferior orbital margin.

·         O’Brien’s block: Facial nerve is blocked at the neck of mandible

·         Nadbath block: Facial nerve is blocked near the stylomastoid foramen.

·         Atkinson’s block: Only superior branches of facial nerve are blocked by an injection at the inferior margin of zygomatic bone.

·         Retrobulbar block was introduced by Herman Knapp in 1884. It is administered by injecting 2 ml of anaesthetic solution (2% xylocaine with added hyaluronidase 5 IU/ ml and with or without adrenaline one in one lac) into the muscle cone behind the eyeball (Fig. 24.3 position ‘B’). It is usual to give the injection through the inferior fornix or the skin of outer part of lower lid with the eye in primary gaze (Fig. 24.4 position ‘B’). The needle is first directed straight backwards then slightly upwards and inwards towards the apex of the orbit, up to a depth of 2.5 to 3 cm.

·         Peribulbar block technique described in 1986 by Davis and Mandel has almost replaced the time-tested combination of retrobulbar and facial blocks, because of its fewer complications and by obviating the need for a separate facial block.