Proparacaine
Anesthetic · Rx
Trade namesAlcaine, Ophthetic, Paracaine
Drug classTopical ester anesthetic (diagnostic)
Strength0.5%
AvailabilityRx
Mechanism of actionBlocks sodium channels in corneal/conjunctival sensory nerve endings; onset ~15-20 s, duration 10-20 min. Least stinging of the topical anesthetics.
Indication / reason for useApplanation tonometry, gonioscopy, foreign-body and suture removal, corneal/conjunctival scraping, punctal procedures, lacrimal irrigation, comfortable examination of a painful eye.
Usual adult dosing1-2 drops immediately before the procedure; repeat once if needed.
PreservativeBAK 0.01%
Contact lensesRemove lenses; a lens may be reinserted once corneal sensation has fully returned (≥20-30 min).
Common / important adverse effectsTransient stinging, punctate epithelial keratopathy, transient loss of the blink/protective reflex. Rare immediate hypersensitivity.
Contraindications & cautionsNever dispense for home use, repeated topical anesthetic abuse causes ring infiltrates, epithelial defects, stromal melt and permanent scarring.
Pregnancy / lactationSingle diagnostic use considered low risk.
Practice notesPatch or advise protection until the anesthetic wears off; document that no lens/rubbing occurs while numb. Store refrigerated; discard if discolored.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.