Rare Contralateral Ocular Complication after Intraoral Anesthetic Injection: A Case Series

Abstract

Intraoral administration of local anesthesia is inevitable for most of the procedures in endodontics. It may be accompanied by ocular complications that are reasonably rare and transient in nature but can cause discomfort for both the patient and the clinician. Most literatures have reported complications that occurred ipsilateral to the injection site. Very rarely contralateral disturbances of eyes are reported. This case series reports two cases in which one case was followed by ptosis, pain, and discomfort of an eye after administering an inferior alveolar nerve block. The other was immediately followed by twitching, pain, and discomfort of an eye after the maxillary infiltration technique. Complete recovery was achieved without any interventions. In this article, we are reporting multiple cases of contralateral complications along with a scientific explanation for this phenomenon and its prevention and management. Key messages: Although contralateral ocular complications are transient, potential sequelae including blindness should be considered. Measures like initial aspiration, slow injection of anesthetic solution, usage of a 25-G needle, and management of patient anxiety reduce the chance of ocular complications.