title: Topical ocular anesthetic abuse: case report.
abstract: Topical ocular anesthetic abuse is uncommon in our clinical experience. The complications associated with topical ocular anesthetic abuse included persistent corneal epithelial defect, ring-shaped stromal infiltrate, and anterior segment inflammation. This disorder can masquerade as Acanthamoeba keratitis or other infectious keratitis. We report a suspicious case of infectious keratitis unresponsive to antibiotics. The patient had an irritable manner, low pain-control threshold, and an analgesic drug abuse history. This information, along with finding a topical ocular anesthetic bottle at bedside helped alert us to possibility of drug abuse. After discontinuing use of the topical anesthetic and using lubricants, topical steroid, and a therapeutic soft contact lens, the condition improved.
authors.affiliation: Department of Ophthalmology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
authors.forename: M H
authors.initials: MH
authors.lastname: Sun
authors.forename: S C
authors.initials: SC
authors.lastname: Huang
authors.forename: T L
authors.initials: TL
authors.lastname: Chen
authors.forename: R J
authors.initials: RJ
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000009:adverse effects*; D006801:Humans; D007634:Keratitis / Q000209:etiology* / Q000628:therapy; D008297:Male; D019966:Substance-Related Disorders / Q000150:complications*
chemical_list: D000779:Anesthetics, Local