Retrobulbar Injection of Anesthetic Within the Muscular Cone

The cone injection discussed in this article is a retrobulbar injection made just posterior to the globe within the muscular cone. The technic of retrobulbar or orbital injection differs greatly, as does the actual location where the solution is injected. It seems desirable to be more specific in referring to orbital injections because very different results may be expected when the injection is within and when it is outside the muscular cone. About two months after cocaine was introduced by Koller, 1 Knapp 2 reported on the use of retrobulbar injection of cocaine hydrochloride to produce anesthesia for enucleation. However, this method of producing anesthesia of the globe did not meet with general approval, probably owing to the alarming toxic effects that followed the strong solutions of cocaine hydrochloride that were used. Some years later, Siegrist, 3 Lowenstein, 4 Seidel 5 and others revived the use of retrobulbar