ArticleJournal of occupational medicine and toxicology (London, England)2025
Topical anesthetic abuse keratopathy: an overlooked occupational eye health concern.
Article in Journal of occupational medicine and toxicology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Clinical presentations, complications, and outcomes of benoxinate topical ophthalmic anesthetic abuse: a retrospective cohort study.Journal of ophthalmic inflammation and infection · 2026Article
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundTopical anesthetic abuse keratopathy is a rare but potentially devastating complication that may lead to irreversible vision loss. In occupational settings, workers who sustain frequent ocular injuries may self-administer topical anesthetics without prior prescription, consequently increasing the risk of severe complications. This study evaluated the clinical findings and visual outcomes of patients with this condition.
methodsAll patients diagnosed with topical anesthetic abuse keratopathy who presented to Khalili Hospital, Shiraz, Iran, from March 2023 to March 2025 were included. Demographics, duration of abuse, risk factors, microbial culture results, treatments, and corrected distance visual acuity (CDVA) at admission and three-month follow-up were analyzed.
resultsThirteen patients (14 eyes; mean age, 43.15 years; 12 males, 1 female) were included. The median duration of abuse was 8.5 days (IQR = 2). Occupational exposures were the primary risk factors, including welding (5/13, 38.5%), metal grinding (3/13, 23.1%), construction work (2/13, 15.4%), and plumbing (2/13, 15.4%). Additionally, one case (1/13, 7.7%) had a history of drug abuse. Cultures were negative in 7 cases (53.8%); positive results included Staphylococcus aureus (3/13, 23.1%), Staphylococcus epidermidis (3/13, 23.1%), and Streptococcus pneumoniae (1/13, 7.7%). Following topical anesthetic cessation, all patients received supportive therapy with lubricants and broad-spectrum antibiotics. Four patients (30.8%) required hospitalization, and one (7.7%) with a history of drug abuse developed corneal perforation. The proportion of eyes with Snellen visual acuity ≥ 5/10 increased from 2/14 at baseline to 12/14 at follow-up. Median CDVA improved significantly from 0.61 (IQR 0.50) to 0.154 (IQR 0.125) LogMAR at 3 months (p < 0.001).
conclusionsTopical anesthetic abuse keratopathy is a serious public health concern with potential complications such as infectious keratitis and corneal perforation. Public education, workplace protection, and stricter regulations are essential to reducing the burden of this vision-threatening disorder.
trial registrationNot applicable.
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