Motor Block of Extraocular Muscles by Deep Orbital Injection

THE VALUE of retrobulbar anesthesia has been appreciated by the majority of ophthalmic surgeons ever since Elschnig's1work was published, in 1925. He pointed out that this method of anesthesia produced a lowering of the intraocular tension, as well as anesthesia. Elschnig,2Grósz,3Dunphy,4Greenwood and Grossman,5my brother, Sanford Gifford,6and others, all expressed the belief that retrobulbar anesthesia reduced the percentage of cases of loss of vitreous in cataract extractions. In my study7on loss of vitreous, I demonstrated that the extraocular muscles were capable of producing the massive losses that occur in about 10 per cent of cases of loss of vitreous. The tonus of these muscles also contributes to the production of the smaller losses of vitreous. I stated the belief that a more complete motor block of the extraocular muscles would prevent the massive loss of vitreous and