The photic sneeze reflex and ocular anesthesia

Ophthalmic Surg Lasers. 1999 Mar;30(3):208-11.


Background and purpose: Intravenous sedation to minimize discomfort from local anesthetic injection has many potential complications including severe involuntary sneezing (i.s.). This prospective study evaluates the occurrence of i.s. and a history of photic sneezing (p.s.).

Methods and materials: All patients receiving local anesthesia (retrobulbar or periocular injections) after intravenous thiopentone for eye surgery during eight months were asked about p.s. and observed for i.s.

Results: The 557 patients (40% males) had a mean age of 69.9 years and 14% recalled p.s. (29.5% males). I.s. developed in 5.2% of the 557. Only 7.6% of those with p.s. developed i.s. After periocular injections 23.8% developed as compared to 4.5% after retrobulbar injections. (P < 0.001). There was no relationship between p.s. and i.s. (p = 0.43).

Conclusion: I.s. is not linked to p.s., with males and females at equal risk for either. I.s. is more common after periocular injections.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Local / adverse effects*
  • Anesthetics, Intravenous / administration & dosage
  • Anesthetics, Local / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Injections
  • Light*
  • Male
  • Middle Aged
  • Orbit
  • Prospective Studies
  • Reflex / drug effects*
  • Sneezing / drug effects*
  • Thiopental / administration & dosage


  • Anesthetics, Intravenous
  • Anesthetics, Local
  • Thiopental