Topical ocular anesthetic abuse: case report.

Topical ocular anesthetic abuse is uncommon in our clinical experience. The complications associated with topical ocular anesthetic abuse included persistent corneal epithelial defect, ring-shaped stromal infiltrate, and anterior segment inflammation. This disorder can masquerade as Acanthamoeba keratitis or other infectious keratitis. We report a suspicious case of infectious keratitis unresponsive to antibiotics. The patient had an irritable manner, low pain-control threshold, and an analgesic drug abuse history. This information, along with finding a topical ocular anesthetic bottle at bedside helped alert us to possibility of drug abuse. After discontinuing use of the topical anesthetic and using lubricants, topical steroid, and a therapeutic soft contact lens, the condition improved.