Topical proparacaine abuse resulting in evisceration

A 72-year-old man was admitted to our clinic because of pain in the right eye. Corneal oedema, peripheral anterior synechiae formation and intraocular lens were determined in the right eye. The left eye was normal except for nuclear sclerosis. Intraocular pressure was 35 mm Hg in the right eye and 14 mm Hg in the left eye. The patient was diagnosed as having bullous keratopathy and glaucoma. He was treated with antiglaucoma drugs and artificial tears as an outpatient. Persistent keratopathy was observed at follow-up, despite adequate therapy. In the detailed anamnesis of the patient, we discovered that he had used a topical anaesthetic instead of the prescribed medicine owing to ocular pain. The patient was still using topical anaesthetic eye drops, despite warnings. Finally, evisceration was performed on his right eye because of corneal melting and perforation.