Local Anaesthesia in Ophthalmology

Proxymetacaine (Ophthaine) is a useful short-acting anaesthetic drop that is comfortable to instill and so is particularly useful when examining children. Amethocaine and benoxinate are also widely used but are longer-acting and sting quite markedly. Local anaesthetic drops should not be used as pain relievers on a long-term basis because the anaesthetized cornea becomes ulcerated and severe infection of the eye can occur. Lignocaine (1% or 2%) with or without adrenaline is injected into the eyelids for lid surgery. Local anaesthesia for intraocular surgery is obtained by topical drops, sub-Tenon's injection, periorbital injection (outside the cone of extraocular muscles) or sometimes retrobulbar injection (within the muscle cone) of lignocaine. For a longer effect, this is sometimes combined with marcaine.

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