Toxicities of topical ophthalmic anesthetics

@article{McGee2007ToxicitiesOT,
  title={Toxicities of topical ophthalmic anesthetics},
  author={Hall Thomas McGee and Frederick W. Fraunfelder},
  journal={Expert Opinion on Drug Safety},
  year={2007},
  volume={6},
  pages={637 - 640}
}
Topical ocular anesthesia has been part of ophthalmology for more than a century. The most commonly used drugs today are proparacaine, tetracaine, benoxinate (oxybuprocaine) cocaine and lidocaine. Although generally well tolerated, all these can be toxic, particularly when abused. The most common toxicities are to the ocular surface, but abuse can cause deep corneal infiltrates, ulceration and even perforation. Fortunately, systemic side effects are rare. Cocaine is unique for its higher… 
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Toxicity of topical ophthalmic anesthetics
TLDR
Topical ocular anesthetic abuse can lead to superficial punctate keratitis, persistent epithelial defects, stromal/ring infiltrates, corneal edema, endothelial damage and ocular inflammation, even when used in a dilute concentration.
Hazards of topical ophthalmic drug administration
Neurotrophic Corneal Ulcer after Topical Tetracaine Abuse: Management Guidelines
TLDR
A one-eyed, 48-year-old man referred to us with an eye disorder from a few days ago following corneal foreign body removal is treated with a preservative free artificial tear therapy with lubricants and adding topical autologous serum drop in the appropriate cases shows an interesting result in improving neurotrophic ulcers.
Overview of ocular anesthesia: past and present
TLDR
This study reviews currently used techniques of topical, subconjunctival and regional block anesthesia used in ophthalmic procedures and describes a new ocular anesthetic gel that provides sustained ocular surface anesthesia, minimal side-effects and may also have antimicrobial properties.
Toxic Keratoconjunctivitis
TLDR
Toxic keratoconjunctivitis is an underrecognized complication of ophthalmic drug use and various environmental or occupational exposures and early recognition and appropriate management of TK may help prevent permanent ocular and visual damage.
Treatment of Non-Infectious Corneal Injury: Review of Diagnostic Agents, Therapeutic Medications, and Future Targets
TLDR
Several agents used in the management of ocular surface disease have been found to be useful as part of the therapeutic armamentarium for treatment of corneal injuries, including amniotic membrane therapies, including topical, cryopreserved and dehydrated variants.
Effects of Regular/Dilute Proparacaine Anesthetic Eye Drops in Combination with Ophthalmic Antibiotics on Corneal Wound Healing.
  • Eric Zhang, Suneel Gupta, R. Mohan
  • Medicine, Biology
    Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics
  • 2022
TLDR
Both methods of regular and diluted proparacaine topical application to the cornea are safe, but impede corneal wound healing in vitro and in vivo.
Topical NSAIDs Effect on Corneal Sensitivity
TLDR
Corneal sensitivity decreased significantly from baseline immediately after topical application remaining flat from 0 to 30 minutes and then rising from 45 to 60 minutes back toward baseline in all treatment groups (P < 0.001).
Anesthesia for Ocular Surgery
Options for anesthetizing the eye for surgery include topical anesthesia with or without lidocaine, regional blocks, including retrobulbar, peribulbar, and sub-Tenon blocks, and general anesthesia.…
Keratopathy due to ophthalmic drug abuse with corneal melting and perforation presenting as Mooren-like ulcer: A case report.
TLDR
A severe case of keratopathy presenting as Mooren-like ulcer caused by topical anesthetics and DEX, which were treated via keratoplasty, resulting in useful vision being retained.
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