polidocanol and Blindness

A physician was found guilty of negligence after blindness occurred subsequent to an injection of Aethoxysclerol into the nasal septum. A review of the literature on visual impairment after the injection of various substances in the nose and head is given. The incidence and pathogenesis of blindness after intranasal injections are discussed.

Topics: Blindness; Hemorrhage; Humans; Malpractice; Nasal Septum; Nose Diseases; Polidocanol; Polyethylene Glycols; Sclerosing Solutions

In spite of extensive experience based on animal experiments and human treatment, a unilateral, irreversible amaurosis occurred in one case of paravascular sclerotherapy of epistaxis with Aethoxysklerol. The strict submucosal application of Aethoxysklerol does not cause a mural thrombosis but leads to narrowing of the vessels (e.g., in the region of the Locus Kiesselbachii) due to gradual subepithelial sclerosis of the mesenchymal tissue. Temporary or permanent amaurosis has also been described in cases of injection of local anesthetics or glucocorticoid crystalline suspensions in the facial and neck region. From the pathophysiological point of view, allergic reactions, neuroreflex vascular spasm, or micro embolism of the central retinal artery have to be considered. The incident on which this paper is based led to a liability lawsuit. Judgement was given against the attending doctor because of severe bodily injury.

Topics: Adult; Blindness; Female; Hemorrhage; Humans; Malpractice; Nose Diseases; Polidocanol; Polyethylene Glycols; Sclerosing Solutions