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Last reviewed: 16 Mar 2025
Last updated: 10 Oct 2024
10 Oct 2024

Limit topical anesthetics to single use for initial symptom relief and to aid exam

Repeated use of topical anesthetics may be toxic to the corneal epithelium and may impair healing (e.g., risks corneal melting, ring infiltrates, and infection).[13][15][16]​​​

Topical anesthetics can provide initial symptom relief and aid exam in patients with corneal abrasions or recurrent corneal erosions, but should be limited to single use by a medical professional.[13][15][16]

​Patients should not receive topical anesthetics for use at home.[15]

See Management: approach

Original source of update

Summary

Definition

History and exam

Key diagnostic factors

  • eye pain
  • tearing
  • photophobia
  • blurred vision
  • ciliary flush

Other diagnostic factors

  • presence of foreign body
  • red reflex
  • corneal opacity
  • rust ring
  • blepharospasm

Risk factors

  • eye trauma
  • foreign body in the eye
  • contact lens use
  • working in the automobile industry
  • lack of protective eyewear
  • prior corneal abrasion
  • deployment of airbag during automobile collision

Diagnostic tests

1st tests to order

  • visual acuity
  • fluorescein staining

Tests to consider

  • CT scan of head and orbits

Treatment algorithm

Contributors

Authors

Christopher McStay, MD
Christopher McStay

Associate Professor of Emergency Medicine

Department of Emergency Medicine

Columbia University College of Physicians and Surgeons

New York

NY

Disclosures

CM declares that he has no competing interests.

Peer reviewers

Christopher Tedeschi, MD

Instructor in Clinical Medicine

Emergency Medicine Department

New York Presbyterian Hospital

Columbia University Medical Center

New York

NY

Disclosures

CT declares that he has no competing interests.

Rasik Vajpayee, MD

Chair of Ophthalmology

Corneal and Cataract Surgery

University of Melbourne

Melbourne

Australia

Disclosures

RV declares that he has no competing interests.

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