From the Guidelines
A dental abscess can potentially cause vision loss, particularly if the infection spreads to the orbital region, as highlighted in a 2024 study published in the Journal of the American College of Radiology 1. This risk is especially pertinent in cases of postseptal cellulitis or orbital abscess, which can lead to catastrophic complications including raised orbital pressure, retinal artery/superior ophthalmic vein occlusion, optic nerve injury, cavernous sinus thrombosis, or empyema, all of which can result in vision loss. Key factors that increase the risk of postseptal inflammation and potential vision loss include high neutrophil count, absence of infectious conjunctivitis, gross periorbital edema, age greater than 3 years, and previous antibiotic therapy, as noted in the study 1. The primary role of imaging in such cases is to differentiate preseptal cellulitis from postseptal cellulitis and abscess, and to identify underlying sinusitis and intracranial complications of orbital infections, underscoring the importance of prompt and accurate diagnosis. Some of the warning signs that may indicate the spread of infection from a dental abscess to the orbital region include:
- Severe facial swelling
- Eye pain
- Bulging eyes
- Double vision
- Decreased visual acuity
- Dental pain and infection symptoms Immediate medical attention is crucial if these symptoms develop, with treatment typically involving hospitalization, intravenous antibiotics, possible surgical drainage, and addressing the dental infection source. Given the potential for serious complications, including vision loss, it is essential to prioritize the management of dental abscesses and seek medical attention promptly if symptoms suggestive of orbital involvement occur.
From the Research
Dental Abscess and Vision Loss
- A dental abscess can lead to vision loss due to the spread of infection to the surrounding areas, including the cavernous sinus and the orbits 2, 3, 4, 5.
- Cavernous sinus thrombosis is a rare but serious condition that can occur secondary to the spread of paranasal sinus infections, including those of dental origin 2, 3, 4.
- Symptoms of cavernous sinus thrombosis include proptosis, chemosis, periorbital swelling, and cranial nerve palsies, which can lead to vision loss if left untreated 2, 3.
- A case report published in 2005 highlighted the severe consequences of a tooth extraction, including visual loss, despite the use of antibiotics 5.
- Early and aggressive treatment is critical in preventing the spread of infection and potential vision loss 5.
Treatment and Management
- Treatment of odontogenic infections, including dental abscesses, typically involves surgical drainage and adjunctive antibiotics 6.
- Amoxicillin/clavulanic acid and clindamycin are commonly used antibiotics for the treatment of odontogenic infections, with similar efficacy and safety profiles 6.
- Prompt diagnosis and management are essential in preventing complications, including vision loss, and improving patient outcomes 2, 3, 4, 5.