Clinical case of temporary paretic strabismus as a side effect of anesthesia during removal of a retained tooth

Although there are a considerable number of publications on complications of anesthesia in the maxillofacial surgery and dentistry, complications in the form of strabismus caused by paresis of the branches of the oculomotor nerve are rarely described. The presented clinical case demonstrates the development of temporary paretic strabismus as a side effect of anesthesia during the removal of an retained wisdom tooth of the lower jaw on the corresponding side. The clinic manifested in the form of binocular double vision, discomfort when moving the left eye; when examined by the Belostotsky–Friedman test: simultaneous vision, exotropia up to 10° with a vertical component, limited mobility of the eye to the nose and upward. No treatment was prescribed. The condition resolved itself within 3 days. Binocular vision was restored. Eye movements became completely free, orthophoria. The authors believe that the anesthetic entered the orbit through the infraorbital canal and caused temporary paresis of the motor bundles of the oculomotor nerve innervating the closest inferior oblique muscle. The symptoms stopped after the drug stopped working.