Oxybuprocaine

Oxybuprocaine is the name of a topical eye anesthetic, which is used especially in ophthalmologyand otolaryngology. Oxybuprocaine is sold by Novartisunder the brand names Novesine or Novesin.

Where oxybuprocaine is used specifically

• In ophthalmologyin order to numb the surface of the eye(the outermost layers of the corneaand conjunctiva) for the followig purposes:
  • In order to perform a contact/applanation tonometry.
  • In order to remove small foreign objects from the uppermost layer of the cornea or conjunctiva.
• In otolaryngologyfor numbing the mucous membranesof the nostrils.

Topical eye anesthetics in general

Oxybuprocaine like any other topical eye anesthetic (like for example tetracaine, alcaine, proxymetacaineand proparacaine) can cause irreversible corneal damage and even complete destruction of the cornea when used excessively (excessive use means several times a day during several days or even weeks).

Topical eye anesthetics abuse

Some patients who suffer from eye pain, which is often considerably strong neuropathic paincaused by the irritation of the nerves within the cornea and/or conjunctiva, unfortunately try to illegally obtain oxybuprocaine or other eye anesthetics (for example by stealingthem at their ophthalmologist, by forgingmedical prescriptionsor by trying to order it via an online pharmacy) and secretly use the substance to numb their eye pain, often ending up with irreversible corneal damage or even destruction (which is a vicious cycleand causes even much more pain). Often, such patients finally require corneal transplantation.

This behaviour of the patients could be easily prevented by correct and timely information about centrallyacting substances that drastically reduce such eye pain (see next section). Unfortunately, ophthalmologists often do not inform their patients about the correct treatment of neuropathic eye pain.

Correct medical treatment of prolonged and chronic eye pain

In case of prolonged or chronic eye pain, especially neuropathic eye pain, it is highly advisable to use rather centrallyacting substances like anticonvulsants(pregabalin, gabapentinand in more serious cases carbamazepine) or antidepressants(for example SSRIsor the tricyclic antidepressantamitriptyline) than topical eye anesthetics like oxybuprocaine. Even very small amounts of an anticonvulsant and/or an antidepressant can almost completely stop eye pain and does not damage the eye at all.

References

• Toxic keratopathy associated with abuse of low-dose anesthetic: a case report. PubMed, 2004
• A clinico-pathological case report of necrotizing ulcerating keratopathy due to topical anaesthetic abuse. PubMed, 2002. (Actually a very special case where a medical doctor (!) abused topical eye anesthetics, probably (s)she did not know enough about centrally acting pain relievers

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It uses material from the http://en.wikipedia.org/wiki/Oxybuprocaine Wikipedia article Oxybuprocaine.