The management of corneal abrasions has largely excluded dispensing topical local anesthetics for home use due to concern for corneal toxicity. We have reviewed and critically appraised the available literature evidence regarding the use of topical anesthetics in patients with simple corneal abrasions. Using sequential Delphi review, we have developed these clinical guidelines. Herein are evidentiary summaries and consensus recommendations for 8 specific relevant questions. Our key observation is that for only simple corneal abrasions, as diagnosed and treated in accordance with the full protocol described herein, it appears safe to prescribe or otherwise provide a commercial topical anesthetic (ie, proparacaine, tetracaine, oxybuprocaine) for use up to every 30 minutes as needed during the first 24 hours after presentation, as long as no more than 1.5 to 2 mL total (an expected 24-hour supply) is dispensed and any remainder is discarded after 24 hours. Importantly, although published findings suggest absent harm for short courses, more rigorous studies with a greater cumulative sample size and ophthalmologic follow-up are needed.

中文翻译：

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表面麻醉剂在治疗单纯性角膜擦伤患者中的使用：美国急诊医师学会的共识指南

由于担心角膜毒性，角膜擦伤的治疗很大程度上排除了在家使用局部麻醉剂的情况。我们回顾并严格评估了有关在单纯角膜擦伤患者中使用表面麻醉剂的现有文献证据。通过德尔菲序贯审查，我们制定了这些临床指南。以下是针对8个具体相关问题的证据总结和共识建议。我们的主要观察结果是，对于仅简单的角膜擦伤，按照本文所述的完整方案进行诊断和治疗，似乎可以安全地开出处方或以其他方式提供商业局部麻醉剂（即丙美卡因、丁卡因、奥布卡因）以供每个患者使用。在就诊后的前 24 小时内，根据需要 30 分钟，只要分配总量不超过 1.5 至 2 毫升（预计 24 小时供应量），并且 24 小时后丢弃任何剩余部分。重要的是，尽管已发表的研究结果表明短期课程不存在危害，但仍需要进行更严格的研究、更大的累积样本量和眼科随访。