An interesting case of a unilaterally dilated pupil

Pediatr Emerg Care. 2013 May;29(5):648-9. doi: 10.1097/PEC.0b013e31828e9f39.

Abstract

Facial lacerations from minor trauma are a common presenting complaint to the emergency department. With the increasing availability of topical anesthetics, there is a decrease in the need for injectable local anesthetic and sedation services, facilitating the ease of facial laceration repairs for young children. One such topical anesthetic is a widely used pharmacy preparation of lidocaine 4%-epinephrine 0.1%-tetracaine 0.5% gel (LET). Although the use of LET has decreased the need for injectable lidocaine and sedation for facial lacerations, both of which can be unpleasant for children with potentially life-threatening adverse events, it may still lead to unexpected and untoward adverse events. We explore here a little-known adverse effect of LET in a child who presented to a pediatric emergency department with an eyelid laceration after minor head trauma.

Publication types

  • Case Reports

MeSH terms

  • Anesthetics, Local / adverse effects*
  • Anisocoria / chemically induced*
  • Anisocoria / diagnosis
  • Brain Injuries / diagnosis
  • Child, Preschool
  • Diagnosis, Differential
  • Epinephrine / administration & dosage
  • Epinephrine / adverse effects*
  • Eye Foreign Bodies / complications
  • Eye Foreign Bodies / diagnosis
  • Eyelids / injuries
  • Eyelids / surgery
  • Facial Injuries / diagnosis
  • Facial Injuries / therapy
  • Gels
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Lidocaine / administration & dosage
  • Lidocaine / adverse effects*
  • Male
  • Orbital Fractures / complications
  • Orbital Fractures / diagnostic imaging
  • Oxycodone / therapeutic use
  • Pneumocephalus / etiology
  • Radiography
  • Suture Techniques
  • Tetracaine / administration & dosage
  • Tetracaine / adverse effects*
  • Tonic Pupil / diagnosis

Substances

  • Anesthetics, Local
  • Gels
  • Hypnotics and Sedatives
  • LET, anesthetic
  • Tetracaine
  • Lidocaine
  • Oxycodone
  • Epinephrine