Oxybuprocaine hydrochloride

How it works

It is an ester-type local anaesthetic that blocks voltage-gated sodium channels in corneal and conjunctival sensory nerves, preventing the generation and conduction of pain signals.

Prescribing in practice

• Topical ocular anaesthetics must never be supplied for repeated self-administration or to relieve ongoing eye pain, as prolonged use causes corneal toxicity, delayed healing and severe sight-threatening keratopathy.
• Because the cornea is anaesthetised and the blink reflex abolished, the eye should be protected from injury and debris until sensation returns.
• Use is restricted to clinical procedures under professional supervision.

Monitoring

Use is limited to supervised procedures, with the eye protected and observed until corneal sensation and the blink reflex have fully recovered.

Counselling the patient

• This anaesthetic is for use during your eye procedure only and must never be taken home for repeated use.
• Do not rub your eye while it is numb, and avoid getting anything in it until normal feeling returns.
• The numbness will wear off over a short period after the procedure.

Evidence & guidelines

Topical ester local anaesthetics are long-established agents for ocular surface anaesthesia, with the hazards of repeated use well documented in ophthalmology references and the SPC.