[Transient vision loss caused by scandicaine with added arterenol in the excision of basalioma of the side of the nose].

In facial dermatosurgery, the addition of sympathomimetics to local anaesthetics produces a desirable topical effect by creating an almost bloodless operation field due to transitory vasoconstriction. In an 87-year-old woman suffering from a meningioma that had caused blindness of the left eye, a basal-cell carcinoma was removed from the right side of the nose. The local anaesthetic contained noradrenaline at a concentration of 1:50,000. After the operation, the patient complained of headache and a transient loss of vision. We suggest that noradrenaline caused vasoconstriction of the arteria centralis retinae via arterial periorbital anastomoses. Patients with severe vision disorders should be considered a risk group, in whom sympathomimetics should not be added to local anaesthetics used in skin surgery of the middle and upper face.