Ophthalmologic complications after intraoral local anesthesia

Swiss Dent J. 2014;124(7-8):784-806. doi: 10.61872/sdj-2014-07-08-02.
[Article in English, German]

Abstract

Introduction: The first ophthalmologic complication in conjunction with a dental anesthesia was reported in 1936. The objective of the present study was a detailed analysis of case reports about that topic.

Material and methods: After conducting a literature search in PubMed this study analyzed 108 ophthalmologic complications following intraoral local anesthesia in 65 case reports with respect to patient-, anesthesia-, and complication- related factors.

Results: The mean age of the patients was 33.8 years and females predominated (72.3%). The most commonly reported complication was diplopia (39.8%), mostly resulting from paralysis of the lateral rectus muscle. Other relatively frequent complications included ptosis (16.7%), mydriasis (14.8%) and amaurosis (13%). Ophthalmologic complications were mainly associated with block anesthesia of the inferior alveolar nerve (45.8%) or the posterior superior alveolar nerve (40.3%). Typically, the ophthalmologic complications in conjunction with intraoral local anesthesia had an immediate to short onset, and disappeared as the anesthesia subsided.

Discussion and conclusion: The increased number of ophthalmologic complications after intraoral local anesthesia in females may suggest a gender effect. Double vision (diplopia) is the most frequently described complication, which is usually completely reversible like the other reported ophthalmologic complications.

Keywords: Ophthalmologic complication; intraoral local anesthesia; literature analysis.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anesthesia, Dental / adverse effects*
  • Anesthesia, Local / adverse effects*
  • Anesthetics, Local / adverse effects*
  • Blepharoptosis / chemically induced*
  • Blepharoptosis / diagnosis
  • Blepharoptosis / epidemiology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Eye Diseases / chemically induced*
  • Eye Diseases / diagnosis
  • Eye Diseases / epidemiology
  • Female
  • Humans
  • Injections / adverse effects
  • Injections / instrumentation
  • Male
  • Middle Aged
  • Vasoconstrictor Agents / adverse effects*
  • Vision Disorders / chemically induced*
  • Vision Disorders / diagnosis
  • Vision Disorders / epidemiology
  • Young Adult

Substances

  • Anesthetics, Local
  • Vasoconstrictor Agents