Peribulair

Peribulair refers to the anatomical and clinical area surrounding the globe of the eye, specifically the tissues that lie just outside the orbital cavity. The term is most commonly used in ophthalmic medicine to describe the placement of local anesthetic or therapeutic agents in the space adjacent to the eye but not within the orbital cavity itself. In practice, a peribulair block is a technique used to anesthetize the eyeball for surgical procedures such as cataract extraction, laser therapy, or intraocular surgery. The needle is inserted into the periocular tissues, typically in the lateral canthus region, and the anesthetic is deposited between the sclera and the periosteum of the orbit, providing analgesia while avoiding the vascular and neural structures deep in the orbit.

Peribulair procedures differ from retrobulbar and subtenon techniques. A retrobulbar block involves injection posteriorly behind the globe, placing anesthetic in the retrobulbar space, which can produce a higher risk of globe perforation, optic nerve injury, or severe hemorrhage. The subtenon method, on the other hand, involves injecting medication into the Tenon’s capsule that surrounds the sclera to deliver drugs to the eye wall while minimizing intraocular pressure changes. Because the peribulair space is superficial yet close enough to the ocular surface, it offers a compromise between efficacy and safety, often preferred in patients with higher anatomical risk.

Clinically, peribulair anesthesia is employed not only for surgical sedation but also for delivering anti-glaucoma medication or for diagnostic imaging such as intravenous fluorescein staining of the cornea. The success of the block depends on accurate technique, correct dosage, and patient selection. Complications are rare but can include local tissue edema, mild hematoma, or transient diplopia if surrounding extraocular muscles are affected. Routine postoperative monitoring addresses these potential issues.