The Safety of Topical Anesthetics in the Treatment of Corneal Abrasions: A Review.
BACKGROUND
Despite the fact that topical anesthetics provide superb analgesia to the painful eye, they are not prescribed routinely to patients when they are discharged from the emergency department because of concerns for delayed healing and corneal erosion.


OBJECTIVE
To summarize the evidence for the safety of topical proparacaine and tetracaine for pain relief in patients with corneal abrasions.


METHODS
This is a systematic review looking at the use of topical anesthetic agents in the treatment of corneal abrasions in the emergency department.


RESULTS
Our literature search produced two emergency department-based, randomized, double blind, placebo-controlled studies on human patients with corneal abrasions. Additionally, we found four studies that investigated the application of topical anesthetics in patients who underwent photorefractive keratectomy. All six studies demonstrated that a short course of dilute topical anesthetic provided efficacious analgesia without adverse effects or delayed epithelial healing.


CONCLUSIONS
Limited available data suggests that the use of dilute topical ophthalmologic proparacaine or tetracaine for a short duration of time is effective, though their safety for outpatient use is inconclusive.
Department of Emergency Medicine, New York University School of Medicine/Bellevue Hospital, New York, New York.
Anand
A
Swaminathan
Department of Emergency Medicine, New York University School of Medicine/Bellevue Hospital, New York, New York.
Karalynn
K
Otterness
Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Ken
K
Milne
University of Texas Health Science Center, San Antonio, Texas.
Salim
S
Rezaie
D000779:Anesthetics, Local / Q000009:adverse effects*; D065306:Corneal Injuries / Q000150:complications*; D058447:Eye Pain / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D011430:Propoxycaine / Q000009:adverse effects*; D013748:Tetracaine / Q000009:adverse effects*; D014945:Wound Healing / Q000187:drug effects
D000779:Anesthetics, Local; D013748:Tetracaine; C005717:proxymetacaine; D011430:Propoxycaine
corneal abrasions; proparacaine; tetracaine; topical anesthetic