 Hi, I'm Dr. Lloyd Williams. I'm an ophthalmologist in Salt Lake City, Utah. I specialize in cornea, and today I'm going to be talking to you about using topical anesthetics in your practice. Ophthalmology has the advantage over many other specialties where we're able to easily numb the structure that we work on with just an eye drop without having to do injections. The most common eye drop that I use in my clinic for numbing is proparacane hydrochloride. This is a very common eye drop and it may come under many different brand names in your country, but this is a very useful way of numbing the eye. It stings a little bit, but the stinging is not as severe as tetrachane, so I find it's more comfortable for the patient. I'm going to show you how I administer the eye drops. In this case, I'm going to use just an artificial tear, so I don't numb our model's eye, but the procedure would be exactly the same. So, have the patient tip their head back. You can grasp the upper lid right at the lashes and just put a drop in. Some patients will be better at having a drop placed in their eye than others. In particular, people who are used to wearing contact lenses often aren't bothered at all, but sometimes children or other people who aren't used to having somebody around their eyes will squeeze tightly or make it quite difficult. Also, some patients, either due to neck problems or due to not being able to understand what you're talking or what you're instructing them to do will not be able to tip their head back very much. In that case, if you have a chair that tips back, you can lean the whole chair back and this can help you get the right angle for getting drops in the patient's eye. So, if you tip the chair back, then you have a little bit easier access to the eye and you can place a drop. Another way of doing it, if the patient is being a little bit difficult, is you can pull the lower lid down and make a pocket and then place the drop right into that pocket. Finally, if the patient is really squeezing tightly, so go ahead and squeeze your eyes very tightly, you can place a drop right here at the medial canthus and that drop, some of it will seep in through the lashes in between the palpebral fissure and also generally, once the patient feels that you've let go of their eye and you've sort of moved away, they'll open their eye and what's been sitting in the medial canthus will roll into the eye and I find that technique very useful, particularly in children and especially children in a hospital situation where the child's laying down in a bed, it can be a very good way of getting drops into the eyes. I also recommend that technique to parents when they have a child who's going to need eye drops but is refusing to allow them to put them in. In general, the harder you squeeze and try to pry the eyelids open, the more the patient will resist. A last technique that I think is very useful, particularly for injections into the eye, is to put prepared cane on a cotton swab and really soak it into the swab or you can use tetra cane and then place the swab on the portion of the eye where you're going to do the injection and that can help you get the conjunctiva and sclera more numb in that area so that the patient doesn't move when you're doing the injection and doesn't feel the needle entering the eye. You should always numb the eye first with a drop before doing that so that they don't feel the cotton swab but that can be a very effective way of getting better anesthesia for an injection. So once again I'm Dr. Lloyd Williams, a cornea specialist in Salt Lake City, Utah. I hope this video helps you in your practice. Thanks very much.