Are there ocular anesthetic drops?

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Last updated: February 6, 2025View editorial policy

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From the Guidelines

Yes, there are ocular anesthetic drops.

Ocular Anesthetic Drops

  • The use of topical local anesthetics, such as proparacaine or tetracaine, is necessary prior to certain ophthalmological procedures, as mentioned in the guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults 1.
  • These anesthetic drops are used to numb the eye, allowing for procedures such as ocular hygiene and the removal of inflammatory debris without causing discomfort to the patient.
  • Additionally, anesthetic drops can be used to aid in the diagnosis of neuropathic ocular pain, as part of the "anesthetic challenge test" 1.
  • It is essential to note that the application of topical anesthetics should be done under the supervision of an ophthalmologist, as they can mask the signs of corneal infection 1.
  • Before using any anesthetic drops, corneal sensation should be tested to ensure that the patient's eye can feel the drops, as described in the dry eye syndrome preferred practice pattern 1.

From the Research

Ocular Anesthetic Drops

  • Ocular anesthetic drops are available and have been used in ophthalmology for over a century 2
  • Commonly used ocular anesthetic drops include proparacaine, tetracaine, benoxinate (oxybuprocaine), cocaine, and lidocaine 2
  • These drops are generally well-tolerated but can be toxic, particularly with abuse, and may cause ocular surface toxicity, deep corneal infiltrates, ulceration, and even perforation 2

Types of Ocular Anesthetic Drops

  • Proparacaine is a commonly used ocular anesthetic drop, available in concentrations of 0.5% and 0.25% 3, 4
  • Tetracaine is another ocular anesthetic drop, but it is not FDA-approved and is associated with corneal epithelial toxicity and delayed epithelial healing 5
  • Lidocaine is also used as an ocular anesthetic drop, and a 3.5% gel formulation (Akten) is FDA-approved for all ophthalmic procedures 5

Effects of Ocular Anesthetic Drops

  • Ocular anesthetic drops can affect corneal wound healing, with regular and diluted proparacaine impeding wound healing in vitro and in vivo 3
  • Adjunct antibiotic treatments can have additive negative effects on corneal wound repair 3
  • The effectiveness of 0.5% and 0.25% proparacaine hydrochloride eye drops as topical anesthetics has been compared, with 0.25% proparacaine being a viable alternative to the standard 0.5% concentration in routine ophthalmic procedures 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Toxicities of topical ophthalmic anesthetics.

Expert opinion on drug safety, 2007

Research

Effects of Regular/Dilute Proparacaine Anesthetic Eye Drops in Combination with Ophthalmic Antibiotics on Corneal Wound Healing.

Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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