Abstract
Background
Ophthalmic complications following inferior alveolar nerve anaesthesia are rare. They include transient blindness (amaurosis), ophthalmoplegia, ptosis, mydriasis and diplopia. These events may occur following the intravascular administration of anaesthetic solution and are distressing to both patient and operator alike.
Case report
We report the unusual case of a young patient who experienced amaurosis, total ophthalmoplegia, complete upper eyelid ptosis, mydriasis and periorbital blanching following inferior alveolar nerve anaesthesia. Similar but less profound signs were observed in the same patient on a subsequent occasion. This was following general anaesthesia, during which she had received local anaesthetic prior to mandibular wisdom tooth removal.
Conclusions
Ophthalmic complications following inferior alveolar nerve anaesthesia are rare but distressing events. In particular, amaurosis is an extremely rare event and usually heralds a more sinister pathology such as stroke. Clinicians should be aware of these complications to minimise anxiety and reassure their patients appropriately.
References
Blaxter PL, Britten MJ (1967) Transient amaurosis after mandibular nerve block. Br Med J 1:681
Rood JP (1972) Ocular complication of inferior dental nerve block. A case report. Br Dent J 132:23–24
Goldenberg AS (1983) Diplopia resulting from a mandibular injection. J Endod 9:261–262
Fish LR, McIntire DN, Johnson L (1989) Temporary paralysis of cranial nerves III, IV, and VI after a Gow-Gates injection. J Am Dent Assoc 119:127–128, 130; discussion 129
Marinho RO (1995) Abducent nerve palsy following dental local analgesia. Br Dent J 179:69–70
van der Bijl P, Lamb TL (1996) Prolonged diplopia following a mandibular block injection. Anesth Prog 43:116–117
Wilkie GJ (2000) Temporary uniocular blindness and ophthalmoplegia associated with a mandibular block injection. A case report. Aust Dent J 45:131–133
Webber B, Orlansky H, Lipton C, Stevens M (2001) Complications of an intra-arterial injection from an inferior alveolar nerve block. J Am Dent Assoc 132:1702–1704
Rishiraj B, Epstein JB, Fine D, Nabi S, Wade NK (2005) Permanent vision loss in one eye following administration of local anaesthesia for a dental extraction. Int J Oral Maxillofac Surg 34:220–223
Uckan S, Cilasun U, Erkman O (2006) Rare ocular and cutaneous complication of inferior alveolar nerve block. J Oral Maxillofac Surg 64:719–721
Ngeow WC, Shim CK, Chai WL (2006) Transient loss of power of accommodation in 1 eye following inferior alveloar nerve block: report of 2 cases. J Can Dent Assoc 72(10):927–931
Scott JK, Moxham BJ, Downie IP (2007) Upper lip blanching and diplopia associated with local anaesthesia of the inferior alveolar nerve. Br Dent J 202:32–33
Choi EH, Seo JY, Jung BY, Park W (2009) Diplopia after inferior alveolar nerve block anesthesia: report of 2 cases and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107(6):e21–e24
Paul R, Anand R, Wray P, D'sa S, Brennan PA (2009) An unusual complication of an inferior dental nerve block: a case report. Br Dent J 206:9–10
Blanton PL, Roda RS (1995) The anatomy of local anaesthesia. J Calif Dent Assoc 23:55–65
Pretterklieber ML, Skoopakoff C, Mayr R (1991) The human maxillary artery reinvestigated. Acta Anat 142:281–287
Singh S, Dass R (1960) The central artery of the retina. Br J Ophthalmol 44:193–212
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Williams, J.V., Williams, L.R., Colbert, S.D. et al. Amaurosis, ophthalmoplegia, ptosis, mydriasis and periorbital blanching following inferior alveolar nerve anaesthesia. Oral Maxillofac Surg 15, 67–70 (2011). https://doi.org/10.1007/s10006-010-0238-5
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DOI: https://doi.org/10.1007/s10006-010-0238-5