Topical Anesthetics Can Be Used for Corneal Abrasions

Traditionally, anesthetic eye drops are not used to treat pain caused by corneal abrasion. The topical anesthetics like paracaine and proparacaine when instilled after a corneal abrasion provides relief from pain immediately but it is not prescribed for further use to prevent some possible complications.

A review of some recent studies suggests that it may not be true.


The dogma: Patients with corneal abrasions should not be discharged home with topical anesthetic agents because their use will lead to increased complications, including ulceration, opacification, and vision loss.

The bottom line: The available data supporting the use of topical anesthetics in simple corneal abrasions are far superior to the case reports and case series that discourage it. It would be ideal to have larger multicenter studies, but we can use this information to help guide our practice. This evidence finds it reasonable to give patients with simple corneal abrasions and no contact lenses a 24-hour supply of dilute topical anesthetic (one-tenth of the standard concentration) and ophthalmology follow-up in one to two days.

Therefore prescription of low-dose topical anesthetic under medical supervision can be a safe practice in cases of corneal abrasion.


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