Vision-threatening reactions of hyaluronidase after local anesthesia: A case series and review of literature

Hyaluronidase is an often used drug in ophthalmology to enhance the effect of local anesthesia. Hypersensitivity reaction to hyaluronidase is a rare complication. Various cases showing varied presentations have been reported in the literature. Here, we report three cases presented with hypersensitivity reaction to hyaluronidase, which were more fulminant, presented with proptosis, blisters, necrosis, and loss of corneal sensation. When such a situation arises, early diagnosis, differentiation from infectious etiology, and timely management with immunosuppressive therapy are crucial for these vision-threatening complications.