Keratitis from corneal anesthetic abuse after photorefractive keratectomy

After having photorefractive keratectomy (PRK), a 29-year-old man suffered from delayed epithelial healing and corneal stromal ring infiltrates. All laboratory results including smear, culture, and biopsy for bacteria, herpes simplex virus, and Acanthamoeba were negative. The suspected cause was patient abuse of anesthetics. Subsequently, it was discovered that for 6 months, since just after the PRK, the patient had intermittently used topical proparacaine drops. After all medication was discontinued and the eye pressure patched, the corneal epithelium healed completely. Practitioners should consider the possibility of topical anesthetic abuse in cases of keratitis after PRK.