The Safety of Topical Anesthetics in the Treatment of Corneal Abrasions: A Review

Abstract

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.

Conclusion: 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.

Keywords: corneal abrasions; proparacaine; tetracaine; topical anesthetic.