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Related Concept Videos

Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

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 Systems01:23

Ophthalmic Drug Delivery Systems

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...
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...

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Corneal Epithelial Abrasion with Ocular Burr As a Model for Cornea Wound Healing
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Topical Anesthetics for Corneal Abrasions: Investigating Emergency Department Readmission Rates and Associated Risks.

Austin C Stewart1, Mary Grace Hamlin, Richard Phan

  • 1University of Toledo College of Medicine and Life Sciences (A.C.S., M.G.H., R.P., M.P., B.D., P.G.), Toledo, OH; MetroHealth Medical Center (T.L.S.), Department of Ophthalmology, Cleveland, OH; and Case Western Reserve University School of Medicine (T.L.S.), Department of Ophthalmology and Visual Sciences, Cleveland, OH.

Eye & Contact Lens
|June 15, 2026
PubMed
Summary
This summary is machine-generated.

Prescribing topical ophthalmic anesthetics (TOAs) for corneal abrasions increases emergency department (ED) readmissions. However, timely ophthalmology follow-up (OFU) appears protective against readmission for these patients.

Keywords:
AnestheticsCorneal injuriesEmergency departmentLocal/adverse effectsOphthalmic solutionsPatient readmission

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Corneal Epithelial Abrasion with Ocular Burr As a Model for Cornea Wound Healing
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Area of Science:

  • Ophthalmology
  • Emergency Medicine
  • Health Services Research

Background:

  • Topical ophthalmic anesthetics (TOAs) are sometimes prescribed for corneal abrasions in the emergency department (ED).
  • Concerns exist regarding the safety and potential adverse effects of TOAs, including the risk of increased readmissions.
  • The role of ophthalmology follow-up (OFU) in mitigating these risks is not fully understood.

Purpose of the Study:

  • To determine if TOA prescriptions for corneal abrasions are associated with higher ED readmission rates.
  • To investigate whether OFU modifies the risk of ED readmission in patients treated with TOAs.

Main Methods:

  • Retrospective cohort study using the TriNetX US Collaborative Network (February 2023-February 2026).
  • Adult patients diagnosed with corneal abrasion in the ED were compared: those prescribed TOAs versus matched controls without TOA prescription.
  • Propensity score matching controlled for confounders; primary outcome was 30-day ED readmission.

Main Results:

  • A total of 23,152 eligible patients were analyzed; 11,576 received TOAs.
  • One-month ED readmission was significantly higher in the TOA group compared to controls (6.7% vs. 3.7%).
  • Ophthalmology follow-up within 30 days was associated with reduced readmissions in both TOA and control groups.

Conclusions:

  • Prescribing TOAs for corneal abrasions is linked to an increased risk of ED readmission.
  • Timely OFU demonstrates a protective effect, potentially reducing readmission rates.
  • Findings support ophthalmologist concerns about TOA safety and underscore the need for collaborative guidelines between emergency medicine and ophthalmology.