Yadav Poonam, Nagaraj M, Anitha G, Singh Sweta
Department of Oral and Maxillofacial Surgery, ESIC Dental College and Hospital, Rohini, New Delhi India.
Department of Periodontology and Oral Implantology, ESIC Dental College and Hospital, Rohini, New Delhi India.
J Maxillofac Oral Surg. 2025 Jun;24(3):808-811. doi: 10.1007/s12663-024-02424-w. Epub 2025 Jan 14.
Maximum dental procedures are carried out under local anesthesia. Scarce literature exists about the ophthalmic complications of after intraoral regional anesthesia. In this case report, authors report a case of 58-year-old female patient reporting to the department with chief complaint of pain in decayed tooth in maxilla. On examination, grossly carious maxillary left second premolar was present. Patient experienced diplopia in relation to contralateral eye (right eye), immediately after giving local anesthesia (anterior superior alveolar nerve block and greater palatine nerve block). Other ophthalmic complications like eye movements restriction were not observed. No abnormal eye signs were noticed in ipsilateral eye (left). Patient was anxious and was counseled about the temporary nature of the symptom. The patient was kept under observation, and vitals were stable. Diplopia resolved in 90 min. The specific aim of the case report is to present a rare ophthalmic complication of contralateral diplopia after giving regional block and its management. Although rare, ophthalmological complications are distressful for the patient following intraoral regional blocks. The clinicians should be aware of the ophthalmic complications, associated signs and symptoms, its pathophysiology and psychological impact on the patient. Knowing all this is mandatory to provide best care to the patient. Patient counseling and reassurance play an important role in management of rare ophthalmic complications.
大多数牙科手术在局部麻醉下进行。关于口腔内局部麻醉后眼部并发症的文献稀缺。在本病例报告中,作者报告了一例58岁女性患者,该患者因上颌一颗龋齿疼痛前来就诊。检查发现,上颌左侧第二前磨牙严重龋坏。在给予局部麻醉(上牙槽前神经阻滞和腭大神经阻滞)后,患者立即出现了与对侧眼(右眼)相关的复视。未观察到其他眼部并发症,如眼球运动受限。同侧眼(左眼)未发现异常眼部体征。患者很焦虑,已就症状的暂时性给予了咨询。患者接受观察,生命体征稳定。复视在90分钟内消失。本病例报告的具体目的是呈现区域阻滞术后对侧复视这种罕见的眼部并发症及其处理。虽然罕见,但口腔内区域阻滞术后的眼科并发症会给患者带来痛苦。临床医生应了解眼部并发症、相关体征和症状、其病理生理学以及对患者的心理影响。了解所有这些对于为患者提供最佳护理至关重要。患者咨询和安慰在罕见眼科并发症的处理中起着重要作用。