• G Rocha, I Brunette, and M Le François.
• Department of ophthalmology, McGill University, Montreal, Que.
• Can J Ophthalmol. 1995 Jun 1; 30 (4): 198-202.

ObjectiveTo describe the clinical findings in three cases of abuse of topically administered ophthalmic anesthetics and to review the clinical signs, diagnosis and treatment.DesignCase series.SettingTwo university-affiliated hospitals in Montreal.PatientsThree patients with toxic keratopathy due to abuse of topically applied anesthetics.ResultsThe three patients presented with a nonhealing epithelial defect, marked stromal edema, folds in Descemet's membrane and a typical stromal ring infiltrate. All three required a conjunctival flap, and two underwent penetrating keratoplasty. The drugs (0.5% tetracaine and 0.5% proparacaine) were easily obtained, at the workplace in two cases and by stealing from the ophthalmologist's examining room in the third case.ConclusionsThe unrestricted availability of topically applied ophthalmic anesthetics as over-the-counter medications in Canada must be reevaluated.

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