Electrocardiographic changes during subconjunctival injections

Electrocardiographic changes were investigated in 53 patients during subconjunctival drug injections. Decrease in heart-rate of more than 10% or arrhythmia was observed in 25 (47.2%) of the patients, who were considered to have a positive oculocardiac reflex. In the control group of 35 patients, only 3 (8.6%) were found to have a significant decrease in heart rate during blood sampling from antecubital vein (p = 0.000). Young age was a significant risk factor for oculocardiac reflex during injections (p = 0.01). Patient gender, verbal pain score, satiety, experience of periocular injections, injected drug type were not found to be risk factors. All patients with oculocardiac reflex were asymptomatic; however, it is still wise to have emergency supplies ready for any circulatory derangement during subconjunctival injections.