Context There are several local and systemic complications associated with the administration of intra-oral local anaesthesia. Very few cases of ophthalmic complications following use of intra-oral local anaesthesia are reported till date. Diplopia is one of such very rare Case Description complications that follow a posterior superior alveolar nerve block. This article describes a very rare case report, the possible mechanisms and their management. The patient was administered PSA nerve block for the extraction of the upper left third molar tooth. After the extraction, the patient complained of double vision and not being able to abduct the left eye. The patient recovered completely after the anaesthetic effect wore of. Conclusion The clinician needs to be aware of such ophthalmic complications and their management.

Planning for dental extraction for patients under antiplatelet therapy remains controversial. Still now there is no such agreed protocol regarding the modication of antiplatelet treatment in different doses for patients requiring dental extraction.

The chances of neurological complications following surgical removal of impacted mandibular third molar increase when there is close contact between the inferior alveolar nerve and the tooth root. Thus, it is important to evaluate the topographic relationship between them preoperatively. AIMS AND OBJECTIVES- To assess the possible nerve injury following extraction of impacted mandibular third molar by comparing the relevant panoramic features with cone beam computed tomography (CBCT) ndings and evaluate the diagnostic accuracy of OPG. MATERIAL AND METHODS –A total number of 30 patients requiring surgical removal of impacted mandibular third molar under local anesthesia and having a close relationship between impacted mandibular third molar and inferior alveolar canal in panoramic radiograph were included in the study and were advised for CBCT evaluation. Statistically signicant association w RESULTS - as found between darkening of the root in OPG and absence of narrowing of the canal in CBCT with P value 0.008 (P<0.05) while distribution of darkening of the root (OPG) according to presence or absence of corticalisation (CBCT) was not statistically signicant . The panorami CONCLUSION - c radiographs may be useful to assess the close relationship between mandibular canal and third molar root tip but it cannot appraise the type of intimate relationship present between them for which CBCT is the reliable tool.