Persistent Corneal Epithelial Defect as a Complication of Tetracaine Abuse

To describe the clinical signs, diagnosis and treatment of toxic keratopathy in a patient who abused tetracaine drops.Case Report: A 32-year-old man was referred to the emergency ward of our center with persistent corneal epithelial defect associated with a ring infiltrate in the corneal stroma, without any history of ocular trauma or contact lens use. The patient was hospitalized and a thorough ocular examination was accomplished. A detailed history in our patient revealed topical anesthetic abuse keratitis. The topical anesthetic wasdeliberately taken from the pharmacy without a prescription. The hallmark of topical anesthetic abuse keratitis was a persistent corneal epithelial defect and a complete ring infiltration in the corneal stroma in our case. Functional and anatomic results after appropriate treatment were not favorable in this case.

Although topical anesthetic abuse keratitis is rare, it should be carefully explained to patients that although topical anesthetics numb the eye, more than a few drops can actually prevent healing and may lead to permanent damage. The unrestricted availability of topically applied ophthalmic anesthetics asover-the-counter medications in Iran must be reevaluated.