Allergic contact fingertip dermatitis secondary to proxymetacaine in an ophthalmologist

Overview

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...

Ophthalmic drug delivery faces major limitations due to poor absorption across the corneal membrane. This process is primarily driven by diffusion and is influenced by two main factors: the physicochemical properties of the drug and tear drainage. Most ophthalmic drugs, such as pilocarpine, epinephrine, atropine, and local anesthetics, are weak bases. They are typically formulated at an acidic pH to enhance chemical stability. However, this leads to high ionization, reducing their ability to...

The human eye has a specialized microbiota that reflects its unique anatomical and immunological environment. This low-biomass microbial community predominantly colonizes the conjunctiva and eyelid margins, playing a vital role in ocular surface homeostasis and defense. Despite its proximity to the richly colonized facial skin, the ocular surface maintains a distinct microbial profile due to continuous mechanical and biochemical defense mechanisms.The conjunctival surface hosts fewer microbial...