Diplopia after inferior alveolar nerve block: case report and related physiology

Although inferior alveolar nerve block is one of the most common procedures performed at dental clinics, complications or adverse effects can still occur. On rare occasions, ocular disturbances, such as diplopia, blurred vision, amaurosis, mydriasis, abnormal pupillary light reflex, retrobulbar pain, miosis, and enophthalmos, have also been reported after maxillary and mandibular anesthesia. Generally, these symptoms are temporary but they can be rather distressing to both patients and dental practitioners. Herein, we describe a case of diplopia caused by routine inferior alveolar nerve anesthesia, its related physiology, and management.

[1]  H. Kazancıoğlu,et al.  An Unforeseen Complication Arising From Inferior Alveolar Nerve Block: Is Anemia Possible? , 2013, The Journal of craniofacial surgery.

[2]  P. Saeed,et al.  Ophthalmologic complications after intraoral local anesthesia: case report and review of literature. , 2012, Oral surgery, oral medicine, oral pathology and oral radiology.

[3]  G. Townsend,et al.  Applied anatomy of the pterygomandibular space: improving the success of inferior alveolar nerve blocks. , 2011, Australian dental journal.

[4]  P. Revington,et al.  Amaurosis, ophthalmoplegia, ptosis, mydriasis and periorbital blanching following inferior alveolar nerve anaesthesia , 2011, Oral and Maxillofacial Surgery.

[5]  S. Boynes,et al.  Ocular complications associated with local anesthesia administration in dentistry. , 2010, Dental clinics of North America.

[6]  W. Park,et al.  Diplopia after inferior alveolar nerve block anesthesia: report of 2 cases and literature review. , 2009, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[7]  W. Ngeow,et al.  Transient loss of power of accommodation in 1 eye following inferior alveolar nerve block: report of 2 cases. , 2006, Journal.

[8]  S. Uckan,et al.  Rare ocular and cutaneous complication of inferior alveolar nerve block. , 2006, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[9]  H. Orlansky,et al.  Complications of an intra-arterial injection from an inferior alveolar nerve block. , 2001, Journal of the American Dental Association.

[10]  Stanley F. Malamed,et al.  Handbook of local anesthesia , 1996 .

[11]  A. Goldenberg Diplopia resulting from a mandibular injection. , 1983, Journal of endodontics.

[12]  J. Rood Ocular complication of inferior dental nerve block. A case report , 1972, British Dental Journal.

[13]  M. Zinkernagel,et al.  Ophthalmologic complications after intraoral local anesthesia. , 2014, Swiss dental journal.

[14]  박원서,et al.  Diplopia after inferior alveolar nerve block anesthesia: report of 2 cases and literature review , 2009 .

[15]  P. van der Bijl,et al.  Prolonged diplopia following a mandibular block injection. , 1996, Anesthesia progress.