Transient unilateral vision loss in a dog following inadvertent intravitreal injection of bupivacaine during a dental procedure

Case Description—A 4-year-old castrated male Chihuahua was evaluated because of unilateral vision loss following extraoral administration of a caudal maxillary nerve block during a dental procedure. Clinical Findings—The menace response was absent in the left eye, but the pupillary light reflex was intact. Vitreal hemorrhages and opacities were present on ophthalmic examination of the left eye. Ultrasonographic findings were supportive of the clinical findings. The posterior lens capsule and retina appeared to be undisturbed. Treatment and Outcome—Treatment consisted of administration of carprofen and prophylactic administration of amoxicillin-clavulanate. Vision was clinically normal with an intact menace response 1 week later. Clinical Relevance—Findings indicated that intravitreal injection of the local anesthetic agent should be considered as a potential complication when performing nerve blocks prior to dental procedures in dogs. (J Am Vet Med Assoc 2015;246:990–993).