Visual loss from embolization of the ocular circulation is a rare but devastating complication of injections into the cutaneous and mucocutaneous tissues of the face, scalp, and nasopharynx.1,2 The mechanism seems to be inadvertent intra-arterial injection into the branches of the ethmoidal arteries, with retrograde flow into the ophthalmic artery. Even though the visual symptoms are transient in most cases, permanent visual loss has been reported.3,4
A 37-year-old woman was treated with methylprednisolone acetate injections of the nasal turbinate for chronic allergic rhinitis. A few minutes after the injection, she became dizzy and described a sensation of seeing bright lights in the left eye, with blurring of vision. Examination revealed a best corrected visual acuity of 20/30 in the affected left eye, with 20/20 in the right eye. A paracentral scotoma was present on Amsler grid testing. Results of examination of the pupil and inspection of the anterior