P-Caine

Indications

Proparacaine Hydrochloride (also called proxymetacaine) eye drops are a local anaesthetic used by eye doctors and trained staff to numb the surface of the eye for a short time. This allows eye pressure measurement, removal of foreign bodies or stitches, contact lens fitting, scraping of the eye surface for tests, and short eye procedures.

How It Works

Proparacaine blocks sodium channels in nerve endings on the surface of the eye. This stops pain signals from travelling to the brain, so the eye becomes numb within about 30 seconds, and the effect lasts about 15 to 20 minutes.

Dosage and Administration

Used only by an eye doctor, nurse or optometrist in the clinic or hospital. One or two drops are put into the eye before the test or procedure, and more may be added for longer procedures, as directed by the clinician. It is not given to patients to use at home.

Interactions

Few interactions are known. It may increase the absorption of other eye drops used immediately afterwards. Tell the eye doctor about all medicines, including other eye drops and treatments for glaucoma or myasthenia gravis.

Contraindications

• Allergy to proparacaine or other ester-type local anaesthetics, or to any ingredient.
• Repeated or long-term self-use for eye pain.

Side Effects

Common: brief stinging or burning when drops are put in, and redness. Rarely: allergic reactions with swelling of the eyelids or eye surface. Repeated use can damage the clear front of the eye (cornea), delay healing and cause scarring and loss of vision.

Get urgent medical help for swelling of the face or throat, difficulty breathing, or eye pain, worsening redness or blurred vision that continues after the numbness wears off.

Pregnancy and Lactation

Only a very small amount reaches the body, and single doses in the clinic are generally considered acceptable in pregnancy and breastfeeding when needed. Tell the eye doctor if you are pregnant or breastfeeding.

Precautions and Warnings

• Do not rub or touch the eye until the numbness has fully worn off (about 20 minutes), as you may injure it without feeling it.
• Avoid dust and do not wear contact lenses until feeling returns, unless told otherwise.
• Use with caution in heart disease or overactive thyroid.

Overdose

Overdose is unlikely with eye use. If swallowed, especially by a child, seek medical help.

Therapeutic Class

Topical ophthalmic local anaesthetic (ester type).

Storage

Store in a refrigerator at 2 to 8°C, do not freeze, protected from light, as directed on the pack. Discard if the solution becomes darker. Keep out of the reach of children.