Ring keratitis from topical anaesthetic misuse

Background: Topical anaesthetic abuse is now an established differential di agnosis of ring keratitis. Published evidence suggests that this condition often has a poor prognosis, with the eyes sometimes requiring penetrating k eratoplasty or the patient becoming blind. Method: A case of topical anaesthetic abuse and its subsequent management i s presented. Ocular examination including pachymetry and specular microscop y is reported. Results: The cornea made an excellent recovery, allowing a visual acuity of 6/6. Pachymetry showed corneal thickening and specular microscopy demonstr ated a decreased cell count in the affected eye. Conclusions: With prompt recognition and appropriate treatment the prognosi s for these cases can be excellent. However, there is evidence to suggest p ermanent cellular damage to the endothelium.