Tetracaine eye drops a safe, effective topical analgesia for acute corneal abrasions

Short-term treatment with topical tetracaine relieves pain associated with acute corneal abrasions and minimizes the use of opiates without increasing complications, as shown in a study.

In total, 111 adults (63 percent male) presenting with uncomplicated corneal abrasions in the emergency department (ED) were randomized to receive tetracaine (n=56; median age, 35 years) or placebo (n=55; median age, 38 years) eye drops, administered every 30 minutes as needed for pain for a maximum of 24 hours.

At the 24- to 48-hour follow-up, tetracaine provided greater pain relief than placebo, with corresponding overall numeric rating scale (NRS) pain scores of 1 and 8 (difference, 7; p<0.001). This was despite the greater baseline pain score in the active treatment group (6 vs 0).

Patients in the tetracaine group reported applying the eyedrops more frequently than those in the placebo group (9 vs 5). There was no between-group difference in the number of patients found to have a small residual corneal abrasion on their repeated ED slit-lamp examination (18 percent vs 11 percent).

Finally, tetracaine-treated patients used less hydrocodone than those who received placebo. The complication rates between the two groups were similar.

Based on the findings, ED patients with uncomplicated corneal abrasions can safely use topical anaesthetics for 24 hours as long as they are provided close ophthalmology follow-up and return precautions.