neurotrophic keratitis and topical anesthetic abuse; why?

[Ligament]

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Hoping the experts can educate me. I'm a pain physician.

Had an RN present with s/p neurotrophic keratitis with severe photophobia, referred for potential blocks.

Read that neurotrophic keratitis can be caused by ocular topical anesthetic abuse in medical professionals.

Why would anybody abuse topical anesthetics via the eye? What is the reason?

 

[Doc320]

Immediately after putting the drops, say tetracaine, the eye feels better.

 

[RetinaDude]

Yeah if anyone has a foreign body sensation, or chronic dry eyes, or just plain old irritation, that numbing drop may burn at first but it then takes it all away and makes the eye feel so much better. But, do it over and over again, and the cornea gets very angry and starts developing defects that can lead to big bug problems…..as it sounds like you are aware

 

[Ligament]

Jesus "medical professionals" are this stupid? I thought they were at least getting a buzz out of it ala liquid cocaine or something other than a numb eye.

 

[salami bahama]

I've seen a few patients that walked out of the ED with a bottle of tetracaine (either stolen or given to the patient by the RN or doc). I guess it's in the EM literature that tetracaine is safe for 'short term' use. I just don't think we know how much tetracaine it takes to lead to corneal ulceration, so I believe most ophthalmologists do not recommend its use outside of the clinic/OR.