CornealUlcer-largeWe commonly encounter ocular complaints in the Emergency Department. Eye pain can result from chemical exposure, a foreign body, or infection. The first step involves instilling a few drops of topical anesthetics, such as proparacaine, to provide some pain relief. Occasionally, however, you encounter a patient who just can’t keep his/her eye open because of the fear of eyedrops.

Trick of the Trade

Instead of dripping the anesthetic directly onto the cornea, gently trickle-in the liquid. To do this, first position the patient such that his/her nose is pointing towards the ceiling. Keep the patient’s eye closed. Apply several drops of the anesthetic into the medial canthal well. The solution will slowly work its way under the eyelids to anesthetize the eye.



Michelle Lin, MD
ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD


Professor of Emerg Med at UCSF-Zuckerberg SF General. ALiEM Founder @aliemteam #PostitPearls at Bio:
Michelle Lin, MD