Proparacaína, de aliada a enemiga

Objective. To describe a case of neurotrophic keratitis with corneal perforation secondary to topical anesthetic abuse, emphasizing the importance of early diagnosis and patient education. Case report. A 34-year-old female presented with right eye pain and photophobia. She had been using topical proparacaine every 40 minutes, along with antibiotics and lubricants. Visual acuity was: OD count fingers at 3 meters; OS 7/10. Corneal perforation was diagnosed. Intensive antibiotic treatment, lubrication, atropine and conjunctival and tectonic patch coverage were performed. Conclusion. Unsupervised use of topical anesthetics can cause severe epithelial toxicity, progressive ulceration, and corneal perforation, as occurred in our case. Early detection and timely therapeutic intervention are essential to preserve ocular integrity.