Ring keratitis from topical anaesthetic misuse.
BACKGROUND
Topical anaesthetic abuse is now an established differential diagnosis of ring keratitis. Published evidence suggests that this condition often has a poor prognosis, with the eyes sometimes requiring penetrating keratoplasty or the patient becoming blind.


METHODS
A case of topical anaesthetic abuse and its subsequent management is presented. Ocular examination including pachymetry and specular microscopy is reported.


RESULTS
The cornea made an excellent recovery, allowing a visual acuity of 6/6. Pachymetry showed corneal thickening and specular microscopy demonstrated a decreased cell count in the affected eye.


CONCLUSIONS
With prompt recognition and appropriate treatment the prognosis for these cases can be excellent. However, there is evidence to suggest permanent cellular damage to the endothelium.
Webber
S K
SK
Sydney Refractive Surgery Centre, Chatswood, New South Wales, Australia.
Sutton
G L
GL
Lawless
M A
MA
Rogers
C M
CM
D000328:Adult; D000779:Anesthetics, Local / Q000009:adverse effects*; D003315:Cornea / Q000187:drug effects* / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D007634:Keratitis / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D009883:Ophthalmic Solutions / Q000009:adverse effects; D012651:Self Medication; D019966:Substance-Related Disorders / Q000209:etiology*; D014792:Visual Acuity
D000779:Anesthetics, Local; D009883:Ophthalmic Solutions