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4.
Neuromodulation ; 24(6): 1107-1114, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33945660

RESUMO

OBJECTIVES: Ocular pain symptoms (e.g., hypersensitivity to light and wind, "burning" sensations) can be debilitating and difficult to treat. Neuromodulatory therapies targeting sensory trigeminal and central pain pathways may help treat chronic ocular pain refractory to traditional therapies. The current study evaluates the long-term effects of a trigeminal neurostimulator (TNS) on ocular pain. MATERIALS AND METHODS: Retrospective review of 18 individuals at the Miami Veterans Affairs Eye Clinic with chronic, severe ocular pain who were prescribed and used TNS at home for ≥3 months. The primary outcome measures were 1) ocular symptom intensity over a 24-hour recall period (dryness, pain, light sensitivity, wind sensitivity, burning; rated on 0-10 scales) captured pre-TNS and at monthly follow-up intervals and 2) side effects. The frequency and duration of TNS was a secondary outcome measure. RESULTS: The mean age of the population (n = 18) was 57.5 years (range, 34-85 years) with a male majority (67%). Two individuals discontinued use due to lack of efficacy and one due to confounding health issues. Initial mean weekly frequency of TNS use was 3.7 ± 1.9 sessions of 25.8 min at month 1 and 2.7 ± 2.3 sessions of 28.0 min at month 6. At six months, pain intensity (↓ 31.4%), light sensitivity (↓ 36.3%), wind sensitivity (↓ 32.6%), and burning sensation (↓ 53.9%) were all decreased compared to baseline (p < 0.01 for all); greater decreases in ocular pain were noted in individuals with migraine (n = 10) than those without migraine (n = 8). No significant change was noted in mean dryness scores. Fifteen subjects experienced sedation with TNS use, persisting throughout the follow-up visits. No other adverse effects were communicated by any subjects. CONCLUSION: Our study suggests TNS is a safe, adjunctive treatment option in individuals with severe, chronic ocular pain. Individuals demonstrated gradual, continual improvement in pain symptoms over time within a multimodal approach.


Assuntos
Dor Crônica , Estimulação Elétrica Nervosa Transcutânea , Adulto , Idoso , Idoso de 80 Anos ou mais , Dor Ocular , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Nervo Trigêmeo
5.
Int J Mol Sci ; 22(9)2021 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-33946979

RESUMO

Choline is essential for maintaining the structure and function of cells in humans. Choline plays an important role in eye health and disease. It is a precursor of acetylcholine, a neurotransmitter of the parasympathetic nervous system, and it is involved in the production and secretion of tears by the lacrimal glands. It also contributes to the stability of the cells and tears on the ocular surface and is involved in retinal development and differentiation. Choline deficiency is associated with retinal hemorrhage, glaucoma, and dry eye syndrome. Choline supplementation may be effective for treating these diseases.


Assuntos
Colina/fisiologia , Oftalmopatias/metabolismo , Acetilcolina/biossíntese , Acetilcolina/fisiologia , Animais , Deficiência de Colina/complicações , Deficiência de Colina/fisiopatologia , Retinopatia Diabética/fisiopatologia , Síndromes do Olho Seco/tratamento farmacológico , Síndromes do Olho Seco/metabolismo , Síndromes do Olho Seco/fisiopatologia , Oftalmopatias/etiologia , Oftalmopatias/fisiopatologia , Dor Ocular/fisiopatologia , Glaucoma/fisiopatologia , Glicerilfosforilcolina/uso terapêutico , Humanos , Aparelho Lacrimal/inervação , Aparelho Lacrimal/metabolismo , Cristalino/metabolismo , Nociceptividade/fisiologia , Nervo Óptico/metabolismo , Sistema Nervoso Parassimpático/fisiopatologia , Fosfatidilcolinas/biossíntese , Fosfolipídeos/metabolismo , Receptores Nicotínicos/fisiologia , Retina/crescimento & desenvolvimento , Retina/metabolismo , Vasos Retinianos/metabolismo , Lágrimas/metabolismo
6.
Am J Emerg Med ; 48: 279-281, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34022635

RESUMO

Periorbital swelling is a common presentation to the emergency department (ED), and its etiology can range from benign to acutely vision-threatening. Orbital subperiosteal hematoma is a rare ED diagnosis that is typically associated with trauma, though can infrequently occur spontaneously in the setting of sudden elevations in cranial venous pressure, bleeding diathesis, and sinusitis. We present a case of a 55-year-old female with a history of chronic sinusitis who presented to the ED with a three-day history of left-sided periorbital swelling along with painful extraocular movements and markedly decreased visual acuity following a cross-country road trip through elevation. Contrast computed tomography scan of the orbits revealed a large extraconal collection in the subperiosteal space causing significant mass effect on the left globe, along with findings of diffuse sinonasal disease bilaterally. Intravenous antibiotics were started immediately and the patient underwent surgical incision and drainage of the subperiosteal space, where she was diagnosed with a spontaneous subperiosteal orbital hematoma secondary to chronic sinusitis. Within the literature, there are fewer than 20 case reports of orbital subperiosteal hematoma secondary to sinusitis. The purpose of this case report is to assist emergency physicians in considering the rare but potentially vision-threatening condition of spontaneous subperiosteal orbital hematoma within their differential diagnosis of patients with periorbital swelling and proptosis, as well as to provide an approach to management within the ED.


Assuntos
Hematoma/diagnóstico por imagem , Doenças Orbitárias/diagnóstico por imagem , Periósteo/diagnóstico por imagem , Sinusite/diagnóstico por imagem , Antibacterianos/uso terapêutico , Doença Crônica , Drenagem , Exoftalmia/fisiopatologia , Dor Ocular/fisiopatologia , Feminino , Hematoma/etiologia , Hematoma/fisiopatologia , Hematoma/terapia , Humanos , Pessoa de Meia-Idade , Doenças Orbitárias/etiologia , Doenças Orbitárias/fisiopatologia , Doenças Orbitárias/terapia , Sinusite/complicações , Tomografia Computadorizada por Raios X , Transtornos da Visão/fisiopatologia
7.
Sci Rep ; 11(1): 9446, 2021 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-33941792

RESUMO

A variety of eye-related symptoms due to the overuse of digital devices is collectively referred to as computer vision syndrome (CVS). In this study, a web-based survey about mind and body functions, including eye strain, was conducted on 1998 Japanese volunteers. To investigate the biological mechanisms behind CVS, a multi-trait genome-wide association study (GWAS), a multivariate analysis on individual-level multivariate data, was performed based on the structural equation modeling methodology assuming a causal pathway for a genetic variant to influence each symptom via a single common latent variable. Twelve loci containing lead variants with a suggestive level of significance were identified. Two loci showed relatively strong signals and were associated with TRABD2B relative to the Wnt signaling pathway and SDK1 having neuronal adhesion and immune functions, respectively. By utilizing publicly available eQTL data, colocalization between GWAS and eQTL signals for four loci was detected, and a locus on 2p25.3 showed a strong colocalization (PPH4 > 0.9) on retinal MYT1L, known to play an important role in neuronal differentiation. This study suggested that the use of multivariate questionnaire data and multi-trait GWAS can lead to biologically reasonable findings and enhance our genetic understanding of complex relationships among symptoms related to CVS.


Assuntos
Computadores , Oftalmopatias/fisiopatologia , Dor Ocular/fisiopatologia , Proteínas do Tecido Nervoso/genética , Retina/fisiopatologia , Fatores de Transcrição/genética , Adulto , Idoso , Moléculas de Adesão Celular/genética , Oftalmopatias/genética , Dor Ocular/genética , Feminino , Predisposição Genética para Doença/genética , Estudo de Associação Genômica Ampla , Genótipo , Humanos , Internet , Masculino , Metaloendopeptidases/genética , Pessoa de Meia-Idade , Locos de Características Quantitativas/genética , Inquéritos e Questionários , Via de Sinalização Wnt/genética , Adulto Jovem
8.
Pan Afr Med J ; 38: 166, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33995773

RESUMO

Orbital inflammatory disease, sequel to epidemic keratoconjunctivitis is an uncommon finding in adult patients. A 36-year-old male presented at the clinic with a 4-day history of left ocular pain and a one-month history of left eye redness and watering. Visual acuity in the eye was 6/5, with reduced red-color saturation and light brightness appreciation. Left eye examination showed periorbital fullness, a palpably enlarged and tender lacrimal gland, conjunctival follicles with pseudomembranes, and restriction of extraocular motility. Magnetic resonance imaging showed homogenous enhancement of the left lacrimal gland, lateral rectus muscle, pre and post-septal soft tissues. A diagnosis of left orbital inflammatory disease secondary to epidemic keratoconjunctivitis was made and patient was treated with high dose oral steroids over the course of 7 weeks, with complete resolution of clinical symptoms. In conclusion, orbital inflammatory disease can develop following epidemic keratoconjuctivitis in adults with good clinical response to oral steroids. Clinicians should have a high index of suspicion when assessing adult patients for orbital inflammatory disease.


Assuntos
Inflamação/etiologia , Ceratoconjuntivite/complicações , Doenças Orbitárias/etiologia , Adulto , Dor Ocular/etiologia , Glucocorticoides/administração & dosagem , Humanos , Inflamação/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Doenças Orbitárias/diagnóstico , Resultado do Tratamento , Acuidade Visual
11.
J Craniofac Surg ; 32(2): e219-e220, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33705080

RESUMO

ABSTRACT: Subperiosteal orbital hemorrhage in the postpartum period has been rarely reported. The authors herein present a female patient who developed acute-onset vertical diplopia, proptosis, mild retro-orbital pain, and restriction of upgaze immediately after labor. Neuroimaging revealed a subperiosteal hematoma along the right orbital roof. Diplopia, motility limitation, and retro-orbital pain gradually resolved in the following weeks. Subperiosteal orbital hematomas are a rare complication of labor, with only 12 cases reported so far. They result from straining during labor, which increases central and orbital venous pressure by means of the Valsalva-maneuver. In order to evaluate ocular motility and exclude optic nerve compression, an urgent ophthalmological examination is required.


Assuntos
Exoftalmia , Hemorragia Retrobulbar , Diplopia , Exoftalmia/etiologia , Dor Ocular , Feminino , Hematoma/diagnóstico por imagem , Hematoma/etiologia , Humanos , Hemorragia Retrobulbar/diagnóstico por imagem , Hemorragia Retrobulbar/etiologia
12.
Invest Ophthalmol Vis Sci ; 62(3): 26, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33729475

RESUMO

Purpose: The purpose of this study was to test the role of substance P (SP) and its receptor neurokinin 1 (NK1R) on ocular surface pain. Methods: Eight-week-old C57BL6/N (wild type [WT]) and B6.Cg-Tac1tm1Bbm/J (TAC1-KO) male mice were used. 5 M NaCl was topically applied on the cornea, followed by topical fosaprepitant 2, 10, and 50 mg/mL; 4 mg/mL oxybuprocaine chloride, or 0.1% diclofenac. Th eye wiping test was used to quantify ocular surface pain. SP content was quantified in the tear fluid and trigeminal ganglia (TG), and TAC1 mRNA was assessed in the cornea. Corneas were immunostained for ß3-tubulin and NK1R, or CD45, to quantify leukocyte infiltration. Results: TAC1-KO mice displayed a significant reduction of ocular pain (P < 0.001). Similarly, a single dose of 10 or 50 mg/mL fosaprepitant applied topically to WT mice reduced ocular pain as compared to vehicle (P < 0.001). Fosaprepitant 2 mg/mL, instead, induced corneal analgesia only when it was administered for 10 days, 6 times/day (P < 0.05). Diclofenac or oxybuprocaine reduced corneal nociception when compared to vehicle or fosaprepitant (P < 0.05). Fosaprepitant or oxybuprocaine groups showed lower SP content in tear secretions and TG (P < 0.05), and reduction in TAC1 mRNA (P < 0.05), and leukocyte infiltration (P < 0.05) in the cornea. Colocalization of NK1R and ß3-tubulin was detected in mouse corneas. Conclusions: Topical administration of the NK1R antagonist fosaprepitant effectively reduces ocular surface nociception by decreasing SP release in the tear fluid and TG, and corneal leukocyte infiltration. Fosaprepitant repurposing shows promise for the treatment of ocular pain.


Assuntos
Doenças da Córnea/prevenção & controle , Dor Ocular/prevenção & controle , Morfolinas/uso terapêutico , Antagonistas dos Receptores de Neurocinina-1/uso terapêutico , Administração Oftálmica , Animais , Córnea/inervação , Modelos Animais de Doenças , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Antagonistas dos Receptores de Neurocinina-1/metabolismo , Nociceptividade/efeitos dos fármacos , Soluções Oftálmicas , Substância P/metabolismo , Lágrimas/metabolismo , Nervo Trigêmeo/metabolismo
13.
Acta méd. colomb ; 46(1): 49-49, ene.-mar. 2021. graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1278157

RESUMO

Masculino de 71 años, hipertenso, con tabaquismo activo (IPA 51); ingresó a urgencias por disminución progresiva de la agudeza visual bilateral hasta llegar a amaurosis bilateral, no dolor ocular. Asociado a cefalea crónica frontal bilateral, pulsátil. RNM cerebral mostró engrosamiento difuso de la meninge en relación con paquimeningitis. Biopsia de meninge mostró paquimeninge. Se descartaron casusas neoplásicas, infecciosas, autoinmunes, por lo cual se consideró una paquimeningitis hipertrófica idiopática (PHI). La paquimeningitis hipertrófica es una entidad clínica rara caracterizada por engrosamiento localizado o difuso de la duramadre, con o sin una inflamación asociada, produce déficit neurológico progresivo por compresión de las estructuras adyacentes (1). El dolor de cabeza es el síntoma inicial más común, seguido de síntomas oftalmológicos, como pérdida visual y diplopía (2). Su etiología es multifactorial, en estudios de imagen se encuentra engrosamiento dural en la fosa craneal posterior (2), imitando la torre Eiffel iluminada en noche (signo de Eiffel de noche) (3).


A 71-year-old hypertensive male who was an active smoker (IPA 51) was admitted to the emergency room due to progressively decreasing bilateral eyesight to the point of bilateral amaurosis, without ocular pain. This was associated with a chronic bilateral pulsatile frontal headache. A brain NMR showed diffuse meningeal thickening related to pachymeningitis. A meningeal biopsy showed pachymeninge. Neoplastic, infectious and autoimmune causes were ruled out; therefore, it was considered to be idiopathic hypertrophic pachymeningitis (IHP). Hypertrophic pachymeningitis is a rare clinical entity characterized by localized or diffuse thickening of the dura mater, with or without associated inflammation. It causes progressive neurological deficit due to compression of the adjacent structures (1). Headache is the most common initial symptom, followed by ophthalmological symp-toms such as vision loss and diplopia (2). Its etiology is multifactorial. Dural thickening in the posterior cranial fossa, mimicking the Eiffel Tower illuminated at night (Eiffel-by-night sign), is found on imaging studies. References 1. Uchida H, Ogawa Y, Tominaga T. Marked effectiveness of low-dose oral methotrexate for steroid-resistant idiopathic hypertrophic pachymeningitis: Case report. Clin Neurol Neurosurg. 2018 May;168:30­3. 2. Hahn LD, Fulbright R, Baehring JM. Hypertrophic pachymeningitis. J Neurol Sci. 2016 Aug;367:278­83. 3. Dash GK, Thomas B, Nair M, Radhakrishnan A. Clinico-radiological spectrum and outcome in idiopathic hypertrophic pachymeningitis. J Neurol Sci. 2015 Mar;350(1­2):51­60. Figure 1. A: Brain NRM with gadolinium, coronal view. Diffuse meningeal thickening, mainly on the right, with significant enhancement on diffuse gadolinium application, compatible with pachymeningitis. B: Orbital NRM with gadolinium. Diffuse pachymeningitis changes which reach the left and right orbital fissures. Figure 2. Meningeal biopsy (H&E 40X). Fibroconnective tissue can be seen, with fibroblast proliferation, increased collagen, cal-cifications and mononuclear inflammatory infiltrate throughout its thickness, compatible with pachymeninge.


Assuntos
Humanos , Feminino , Idoso , Acuidade Visual , Meningite , Visão Ocular , Biópsia , Fossa Craniana Posterior , Diplopia , Dor Ocular , Cefaleia
14.
Curr Opin Ophthalmol ; 32(3): 209-213, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33710008

RESUMO

PURPOSE OF REVIEW: The number of opioid-related overdose deaths has rapidly increased since 2000, increasing more than five-fold from 1999 to 2016. Although surgeons only write 10% of opioid prescriptions annually, with ophthalmologists writing only a fraction of this amount, all physicians need to be cognizant of the current opioid epidemic and ways to decrease unnecessary opioid prescriptions. RECENT FINDINGS: Previous work within ophthalmology has shown that retrobulbar anesthesia along with peri-operative intravenous or oral nonopioid analgesics can lead to decreased postoperative opioid use following ophthalmic surgery. Recent literature has shifted focus towards the use of opioid prescription guidelines in managing postoperative pain and decreasing the number of unnecessary opioids being prescribed by ophthalmologists. Overall, the frequency of opioid prescriptions may have gradually declined the past few years with such efforts, increased awareness, and new healthcare policies to monitor opioid prescriptions. However, ophthalmologists still continue to prescribe a substantial number of opioid medications, much of which may not be necessary. SUMMARY: This review serves as a tool to aid all ophthalmologists in managing postoperative pain. There is a recent trend in addressing the opioid epidemic and efforts are being made to limit the overprescribing of opioids. Continued efforts are still required by all ophthalmologists to address the current opioid epidemic.


Assuntos
Analgésicos Opioides/administração & dosagem , Dor Ocular/tratamento farmacológico , Procedimentos Cirúrgicos Oftalmológicos , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Dor Pós-Operatória/tratamento farmacológico , Prescrições de Medicamentos/normas , Humanos , Oftalmologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Padrões de Prática Médica/normas
15.
Minerva Anestesiol ; 87(5): 541-548, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33594870

RESUMO

BACKGROUND: Pars plana vitrectomy (PPV), a surgical procedure used to treat different ophthalmic pathologies, could be associated with moderate to severe eye pain. The aim of the present study was to evaluate the incidence of postoperative eye pain and its risk factors following PPV in a selected population of patients with non-painful eye disease, receiving regional anesthesia and moderate sedation with benzodiazepines, without use of narcotics. METHODS: Single-center, prospective observational cohort study. We recorded the presence of pain at operating room discharge, at 6 and 24 hours, using the numeric rating scale (NRS). We recorded also age, sex, ethnic origin, American Society of Anaesthesia physical status (ASA PS) classification, Charlson Comorbidity Index, the etiology of the vitreoretinal pathology, length of surgery, and type of surgical procedure performed. RESULTS: Eye pain (NRS>3) was present in three patients (0.7%) at operating room discharge, 59 (13.2%) at six and 65 (14.6%) at 24 hours after surgery. LASSO logistic regression analysis identified age, ASA PS, race, along with tamponade as independent risk factors for eye pain at six hours. Scleral buckling was selected for eye pain at 24 hrs. CONCLUSIONS: A protocol for pain control after PPV should be considered, especially in younger, non-Caucasian people, and patients with high ASA PS grade. Moreover, attention must be paid when additional surgical procedures are requested, restricting them to selected patients, and using the appropriate agent for intraocular tamponade.


Assuntos
Descolamento Retiniano , Vitrectomia , Dor Ocular , Humanos , Estudos Prospectivos , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Fatores de Risco , Acuidade Visual
16.
Eur J Endocrinol ; 184(2): 277-287, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33539318

RESUMO

Background: Tripterygium glycosides (TG) has been used to treat a spectrum of inflammatory and autoimmune diseases. Our preliminary studies have shown that TG is effective in the treatment of active Graves' ophthalmopathy (GO). Objective: We aimed to compare the efficacy and tolerability of TG with intravenous methylprednisolone (iv.MP) in patients with active moderate-to-severe GO. Methods: This study was an observer-masked, single-centre, block-randomised trial. Patients with active moderate-to-severe GO were randomly assigned to receive iv.MP (500 mg once per week for 6 weeks followed by 250 mg per week for 6 weeks) or with TG (20 mg tablet three times per day for 24 weeks). The primary endpoints were the overall response rate and the patients' quality of life at 12 and 24 weeks. Results: In this study, 161 patients were enrolled and randomised from 2015 to 2019. A total of 79 were randomly assigned to receive iv.MP and 82 to receive TG. A greater overall response rate was found in the TG group compared with the iv.MP group at week 24 (90.2% vs 68.4%, P = 0.000). Similarly, the patients' quality of life of the TG group showed a significantly higher response than the iv.MP group at week 24 (89.02% vs 72.15%, P = 0.001). The TG therapy showed a better CAS response than the iv.MP (91.5% vs 70.9% improved, P < 0.05), and up to 91.2% of patients were inactive. Also, the TG group showed a significantly higher improved rate of diplopia, proptosis, visual acuity, soft tissue involved and the decrease of eye muscle motility than the iv.MP group at week 24. Significantly more patients in the iv.MP group than the TG group experienced adverse events. Conclusion: Compared with iv.MP treatment, TG therapy is more effective and safer for patients with active moderate to severe GO.


Assuntos
Glicosídeos/uso terapêutico , Oftalmopatia de Graves/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Tripterygium , Administração Intravenosa , Adulto , Antitireóideos/uso terapêutico , Diplopia/fisiopatologia , Exoftalmia/fisiopatologia , Dor Ocular/fisiopatologia , Feminino , Glucocorticoides/uso terapêutico , Doença de Graves/tratamento farmacológico , Oftalmopatia de Graves/fisiopatologia , Humanos , Hipotireoidismo/tratamento farmacológico , Masculino , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Músculos Oculomotores/fisiopatologia , Índice de Gravidade de Doença , Método Simples-Cego , Tiroxina/uso terapêutico , Resultado do Tratamento , Acuidade Visual/fisiologia
17.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33541989

RESUMO

Hypertrophic cranial polyneuropathy (HCP) is sporadically encountered in clinical practice. Aetiologies of HCP have been classified as autoimmune, infectious and demyelinating. However, an accurate diagnosis remains elusive in some cases despite rigorous investigations. These cases represent idiopathic HCP. Given the high clinical variance in presenting symptoms, HCP often leaves medical practitioners in a diagnostic quandary. Here, we seek to expand current knowledge by reporting the first documented case of idiopathic HCP presenting atypically with unilateral orbital pain and exclusively involving the bilateral trigeminal nerves.


Assuntos
Doenças dos Nervos Cranianos/diagnóstico , Diagnóstico Diferencial , Dor Ocular , Hipertrofia/diagnóstico , Polineuropatias/diagnóstico , Nervo Trigêmeo , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Nervo Trigêmeo/patologia
20.
Ann Emerg Med ; 77(3): 338-344, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33121832

RESUMO

STUDY OBJECTIVE: The objective of this study is to show that patients with corneal abrasions would experience more pain relief with short-term topical tetracaine than placebo. METHODS: The study was a prospective, double-blind, randomized trial of tetracaine versus placebo set in the emergency department (ED). A total of 118 adults who presented with uncomplicated corneal abrasions were included and randomized. The intervention was either topical tetracaine or placebo applied every 30 minutes as needed for 24 hours. The primary outcome was the overall numeric rating scale pain score measured at the 24- to 48-hour ED follow-up examination. RESULTS: One hundred eleven patients were included in the final analysis, 56 in the tetracaine group and 55 in the placebo group. At the 24- to 48-hour follow-up, the overall numeric rating scale pain score after use of the study drops was significantly lower in the tetracaine group (1) versus placebo group (8) (Δ7; 95% confidence interval 6 to 8). Patients in the tetracaine group used less hydrocodone than those in the placebo group. The complication rates between the 2 groups were similar. CONCLUSION: Short-term topical tetracaine is an efficacious analgesic for acute corneal abrasions, is associated with less hydrocodone use compared with placebo, and was found to be safe in this sample.


Assuntos
Analgésicos/administração & dosagem , Lesões da Córnea/complicações , Dor Ocular/tratamento farmacológico , Tetracaína/administração & dosagem , Administração Tópica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Analgésicos/uso terapêutico , Método Duplo-Cego , Esquema de Medicação , Dor Ocular/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Tetracaína/uso terapêutico , Resultado do Tratamento , Adulto Jovem
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