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Topical proparacaine abuse resulting in evisceration
Adnan Aksoy1, Ahmet Metin Başkan, Lokman Aslan
1Department of Ophthalmology, Faculty of Medicine, Sutcu Imam University, Kahramanmaraş, Turkey.
BMJ Case Reports
|April 24, 2013
Summary
Misuse of topical anesthetic eye drops led to severe corneal complications, including melting and perforation. This resulted in the evisceration of the patient's right eye, highlighting the dangers of anesthetic abuse.
Area of Science:
- Ophthalmology
- Corneal Disease
- Glaucoma Management
Background:
- A 72-year-old male presented with right eye pain, diagnosed with bullous keratopathy and glaucoma.
- Initial treatment included antiglaucoma medications and artificial tears, but keratopathy persisted.
Observation:
- The patient self-administered topical anesthetic eye drops instead of prescribed medication due to persistent ocular pain.
- Despite warnings, the patient continued using the anesthetic drops, leading to worsening corneal issues.
Findings:
- Persistent bullous keratopathy and elevated intraocular pressure (35 mm Hg) in the right eye.
- Corneal melting and perforation developed secondary to chronic topical anesthetic misuse.
- Evisceration of the right eye was ultimately required due to irreversible corneal damage.
Implications:
- Highlights the critical risk of corneal toxicity and perforation associated with topical anesthetic abuse.
- Underscores the importance of patient education and adherence to prescribed treatments in managing ocular conditions.
- Emphasizes the need for vigilant monitoring in cases of persistent ocular pain and non-adherence.
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