Clinical features, complications, and outcomes of topical anesthetic eye drop misuse

Topical anesthetic eye drops are widely used in ophthalmology; however, improper use may result in serious complications, including blindness.

This descriptive, cross-sectional study examined patients presenting with foreign body sensation, exposure to ultraviolet (UV) radiation, or misuse of topical anesthetic drops at Sina Hospital's Ophthalmology Emergency Department from September 2019 to September 2020. After obtaining informed consent, participants completed questionnaires under the supervision of an ophthalmologist. Patients with anesthetic-related complications received appropriate treatment and were followed up for one month. Data were analyzed using SPSS version 21.

Of 192 patients (185 men and 7 women; mean age: 42.69 ± 12.45 years), 76.56% reported foreign body sensation. The most common symptoms were lacrimation (84.37%) and photophobia (73.95%). Many patients used non-medical remedies such as closing their eyes (63.15%) and applying tea (45.31%). Pharmacy staff (38.27%) and colleagues (33.33%) were the most frequent sources of advice. Tetracaine misuse was significantly more common among patients with a prior history of use (P < 0.001) and was significantly associated with ocular complications, including keratopathy and vision loss (P = 0.011).

Arbitrary use of topical anesthetic drops-often based on non-specialist recommendations-significantly increases the risk of ocular complications. Awareness of potential side effects does not appear to prevent misuse, underscoring the need for stronger educational efforts regarding the risks of topical anesthetics.