Transient loss of power of accommodation in 1 eye following inferior alveolar nerve block: report of 2 cases

Ngeow, W. C.; Shim, C. K.; Chai, W. L. (2006) Transient loss of power of accommodation in 1 eye following inferior alveolar nerve block: report of 2 cases. Journal of the Canadian Dental Association, 72 (10). pp. 927-931. ISSN 1488-2159

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    Unintended intravascular injection from inferior alveolar nerve blocks can result in frustrating distant complications affecting such structures as the middle ear and eyes. Possible complications affecting the eyes include blurring of vision, diplopia, mydriasis, palpebral ptosis and amaurosis ( temporary or permanent). In this article, we present a complication that has been reported only rarely. Two patients developed transient loss of power of accommodation of the eye resulting in blurred vision after routine inferior alveolar nerve blocks on the ipsilateral side. Clear vision returned within 10 - 15 minutes after completion of the blocks. The possible explanation for this phenomenon is accidental injection into the neurovascular bundle of local anesthetic agents, which were carried via the blood to the orbital region. This resulted in paralysis of a branch of cranial nerve III, the short ciliary nerves that innervate the ciliary muscle, which controls accommodation.

    Item Type: Article
    1. Ngeow, W. C.(Univ. Malaya)
    2. Shim, C. K.
    3. Chai, W. L.
    Journal or Publication Title: Journal of the Canadian Dental Association
    Additional Information: Times Cited: 9 Ngeow, Wei Cheong Shim, Chen Kiong Chai, Wen Lin
    Uncontrolled Keywords: anesthesia, dental/adverse effects; diplopia/chemically induced; eye/drug effects; LOCAL-ANESTHESIA; DENTAL-ANESTHESIA; COMPLICATIONS; INJECTION; DIPLOPIA; PALSY
    Subjects: R Medicine
    R Medicine > R Medicine (General)
    R Medicine > RK Dentistry
    Divisions: Faculty of Dentistry > Dept of Oral & Maxillofacial Surgery
    Depositing User: Dr Wei Cheong Ngeow
    Date Deposited: 12 Mar 2012 16:50
    Last Modified: 21 Mar 2012 10:44

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