To the Editor: The oculocardiac reflex is a potentially life-threatening phenomenon requiring prompt recognition and management. It is defined as a 20% or greater reduction in heart rate and/or the presence of arrhythmias during stimulation of the orbital contents.1 It is most commonly encountered in the context of paediatric squint surgery.
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- 1. Ziccardi VB, Russavage J, Sotereanos GC, Patterson GT. Oculocardiac reflex: pathophysiology and case report. Oral Surg Oral Med Oral Pathol 1991; 71: 137-138.
- 2. Aschner B. Über einen bisher noch nicht beschriebenen Reflex, vom Auge auf Kreislauf und Atmung. Verschwinden des Radialispulses bei Druck auf das Auge [Concerning a hitherto not yet described reflex from the eye on circulation and respiration. Disappearance of the radial pulse with pressure on the eye] [German]. Wien Klin Wochenschr 1908; 21: 1529-1590.
- 3. Sires BS, Stanley RB, Levine LM. Oculocardiac reflex caused by orbital floor trapdoor fracture: an indication for urgent surgical repair. Arch Ophthalmol 1998; 116: 955-956.
- 4. Burnstine MA. Clinical recommendations for repair of orbital facial fractures. Curr Opin Ophthalmol 2003; 14: 236-240.
- 5. Sires BS. Orbital trapdoor fracture and the oculocardiac reflex [letter]. Ophthal Plast Reconstr Surg 1999; 15: 301.
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Acknowledgement: We thank Mr Douglas Nash for his assistance in image preparation.