title: Ophthalmologic complications after intraoral local anesthesia.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Switzerland, and Department of Anatomy, Biochemistry and Physiology, University of Hawaii, Honolulu, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: von Arx
authors.affiliation: Department of Anatomy, Biochemistry and Physiology, University of Hawaii, Honolulu, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Lozanoff
authors.affiliation: Department of Ophthalmology, Inselspital University Hospital, Bern, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Zinkernagel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000766:Anesthesia, Dental / Q000009:adverse effects*; D000772:Anesthesia, Local / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D001763:Blepharoptosis / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005128:Eye Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D014662:Vasoconstrictor Agents / Q000009:adverse effects*; D014786:Vision Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents
keywords: Ophthalmologic complication; intraoral local anesthesia; literature analysis