A case of the blue blues: the safety issue of recognizing and avoiding the retinal toxicity of methylene blue compared to brilliant blue and trypan blue

While blue vital dyes remain indispensable in ophthalmic surgery, medication errors, particularly the inadvertent use of methylene blue instead of trypan blue and brilliant blue, pose a significant risk to patient safety. Methylene blue has been reported to cause damage to anterior segment structures, We reported a case of inner retinal toxicity from injection of methylene blue into the vitreous cavity resulting in profound vision loss. Standardization, vigilant verification, and safer packaging are critical to preventing these never events.