Topical Anesthetics for Corneal Abrasions: Investigating Emergency Department Readmission Rates and Associated Risks

To evaluate whether prescribing topical ophthalmic anesthetics (TOAs) for corneal abrasions in the emergency department (ED) is associated with increased ED readmission and whether ophthalmology follow-up (OFU) modifies this risk.

We performed a retrospective cohort study in the TriNetX US Collaborative Network (February 2023-February 2026). Adults with an ED diagnosis of corneal abrasion and a TOA prescription were compared with matched controls without TOA prescription. Patients with prior history of corneal disease were excluded. Propensity score matching controlled for demographics and socioeconomic status. Emergency department readmission at 3, 7, 14, and 30 days was the primary outcome; the association of OFU with 30-day readmission was secondary. Risk ratios (RRs) and risk differences (RDs) were calculated.

Among 23,152 eligible patients, 11,576 received TOAs. One-month ED readmission was higher with TOAs than controls (6.7% vs. 3.7%; RR 1.81; RD 2.99%). Ophthalmology follow-up within 30 days was associated with fewer readmissions in both groups (RR 0.82; RD -1.08%).

Prescribing TOAs for corneal abrasions is associated with increased ED readmission, whereas timely OFU appears protective. These findings support ophthalmologists' concerns about TOA safety and highlight the need for joint emergency medicine-ophthalmology guidelines to optimize patient outcomes.