Topical ocular anesthetic abuse: case report

Area of Science:

• Ophthalmology
• Toxicology

Background:

• Topical ocular anesthetic abuse is rarely encountered.
• Complications include persistent corneal epithelial defects, stromal infiltrates, and inflammation.

Observation:

• A case of infectious keratitis unresponsive to antibiotics was observed.
• The patient exhibited irritability, a low pain threshold, and a history of analgesic abuse.
• A topical ocular anesthetic bottle found at the patient's bedside raised suspicion.

Findings:

• The disorder mimicked infectious keratitis, including Acanthamoeba keratitis.
• Discontinuation of topical anesthetic, coupled with lubricants, topical steroids, and a therapeutic contact lens, led to improvement.

Implications:

• Clinicians should consider anesthetic abuse in non-responsive keratitis cases.
• Awareness of patient history and environmental factors is vital for diagnosis.
• Prompt management can resolve anesthetic-induced ocular damage.