Delayed Corneal Healing After the Use of Topical Ophthalmic Anesthetics

Topical anesthetics for control of pain from corneal abrasions can cause drug-related toxicity that delays corneal healing. This report documents three cases where topical anesthetic drops were prescribed in the emergency department for pain control, after which patients developed persistent ocular pain, epithelial toxicity with impaired healing, and significant loss of vision. On consultation with the ophthalmology service, each patient was instructed to discontinue the topical anesthetic drops but to continue topical antibiotics. Soon thereafter, symptoms resolved, and the corneas healed within 72 hours. This report emphasizes the harm that can result from injudicious and/or unmonitored use of topical anesthetics for corneal abrasions. We advise emergency medicine and primary care providers against providing topical anesthetics to patients with corneal abrasions.