Based on our close personal observation of several patients after blepharoplasty who developed retrobulbar hemorrhage progressing to blindness, the mechanism appears to operate through ischemia of the anterior optic nerve head. Relief of this blindness has followed prompt surgical intervention, with supportive medical therapy. The importance of close nursing observation for some hours after the operation is stressed, as it may be the only means of detecting this complication while the sight can still be saved.
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Heinze et al. (1978) studied this question.