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Toxic epitheliopathy from a single application of preservative free oxybuprocaine (0.4%) in a patient with Sjogren's syndrome
  1. Humaira Ansari1,
  2. Laurence Weinberg2,
  3. Narelle Spencer3
  1. 1Department of Medicine, The Northern Hospital, Epping, Victoria, Australia
  2. 2Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria, Australia
  3. 3Department of Ophthalmology, Austin Hospital, Heidelberg, Victoria, Australia
  1. Correspondence to Dr Laurence Weinberg, laurence.weinberg{at}


Topical ocular anaesthetic agents are frequently used for ophthalmic diagnosis and surgery. While corneal complications following long-term use or misuse of local anaesthetic solutions have been described, toxic epitheliopathy after a single application of six drops of preservative free oxybuprocaine is rare. In order to increase the awareness of this ocular complication, we report such a case in a patient with Sjogren's syndrome who presented for elective cataract surgery. We outline the mechanisms proposed to explain the ocular toxic effects of oxybuprocaine and discuss the management principles in preventing this complication in the context of Sjogren's syndrome.

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