January 28, 2021

Corneal Abrasions and Short-Term Topical Tetracaine

Background: Anyone who has had a corneal abrasion knows how painful it can be.   Unfortunately, traditional analgesic agents (ibuprofen, acetaminophen, opiates etc) are ineffective in relieving pain. Topical anesthetic drops can be diagnostic of superficial eye pathology and are routinely used prior to slit-lamp examination.  They provide immediate relief in the emergency department and have been shown to be effective and safe (Limited evidence has not shown significant adverse events) as short-term outpatient therapy (REBEL EM).  The biggest concern with the use of topical anesthetic agents as outpatient therapy is delayed healing, which is what most evidence has focused on.  This may occur with long-term use, but not been seen in studies of short-term use of topical anesthetics (REBEL EM). Use of short-term topical anesthetics further has the potential to reduce the use of opioids for analgesia for this indication. Recent published literature on topical anesthetic for this indication have focused on harms. There is scant literature detailing their benefit....Read More