Side Effects of Proparacaine on the Eyes

Many eye procedures are done under local anesthetic. Proparacaine hydrochloride, a liquid ophthetic drop, is frequently administered to numb the eye in a doctor's office before certain tests, such as eye pressure exams, or before procedures such as intravitreal injections. As with any medication, proparacaine can cause side effects. Most side effects are mild and short lived, but some can be severe and require medical attention.

Mild side effects

The initial administration of proparacaine eye drops often causes a temporary stinging or burning sensation in the eye. This normally passes within 15 to 20 seconds. Proparacaine can also cause temporary redness of the eye.

Allergic Side Effects

Allergy to proparacaine causes symptoms similar to other medication allergies, such as rash, hives, facial edema, difficulty breathing and sudden collapse. Allergy to proparacaine can also cause a contact dermatitis reaction, resulting in drying and cracking of the fingertips. Notify your doctor immediately if any signs of allergic reaction occur.

A rare and serious allergic reaction to proparacaine affects the cornea, causing epithelial keratitis (an overgrowth of cells); sloughing of the top layer of the cornea; a gray, glassy appearance; and possibly acute iritis, an inflammation of the iris.

Serious Side Effects

Proparacaine use can have serious side effects on the eyes. Continued use of it can lead to softening of the corneal epithelium, the top layer of the cornea. Topical ophthalmic anesthetics like proparacaine can also slow healing of the cornea after an injury, such as corneal abrasion, and could possibly perforate the cornea. Corneal opacification and vision loss are also reported after prolonged use. For this reason, proparacaine should never be given to patients for home use; the risk of overuse could result in permanent eye damage.

While very little of the drug is absorbed systemically, occasional central nervous system reactions, including restlessness, anxiety, seizures, or a slow and irregular heartbeat are seen after proparacaine administration. Proparacaine should be given to cardiac patients only when necessary.

Precautions

Safety has not been established in pregnant women, nursing mothers or pediatric patients. Prolonged use of proparacaine ophthalmic drops may cause delayed wound healing. Patients should report any blurred vision, vision loss, pain or swelling of the eye after proparacaine installation to their doctor immediately, as well as any potential systemic changes such as cardiac symptoms or central nervous system abnormalities.