European journal of ophthalmology
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To describe corneal complications in three patients following abuse of topical anesthetics. ⋯ The initial presentation of this rare clinical entity creates difficulties in reaching a correct diagnosis. A presumed acanthamoeba keratitis is the first choice among many similar conditions. Thus abuse of topical ocular anesthetic drops should be included in the differential diagnosis of cases of chronic keratitis as it may masquerade as acanthamoeba keratitis. A current or past history of psychiatric and mental disorders or psychoactive substance abuse is important in the diagnosis. Functional and anatomical results after appropriate treatment are usually poor. Psychiatric counselling is extremely helpful and is in fact mandatory in the management of these patients.