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Bilateral chemical eye injury due to inadvertent exposure to drug: case report A 60-year-old woman developed bilateral chemical eye injury following inadvertent exposure of local anaesthetic lidocaine/ prilocaine in the eyes during preparation for cosmetic plasma fibroblast skin tightening treatment. The woman underwent cosmetic plasma fibroblast skin tightening treatment under both her eye-lids. She received 5% lidocaine/ prilocaine [EMLA cream; eutectic mixture of local anaesthetics] as a topical anaesthetic prior to procedure and experienced a little discomfort; however, it subsided and she received the fibroblast treatment. Each gram of EMLA cream contains 25mg of lidocaine and 25mg of prilocaine. Approximately 4 hours later, she presented to the emergency department with acute, bilateral, red, painful and photophobic eyes. Additionally, she had reduced vision, periorbital swelling and bilateral corneal injuries. She was then hospitalised. Her visual acuity was found to be 6/12 and 6/24 on right and left eye, respectively; however, the examination was difficult as she was extremely photophobic and had intense pain (rated 10/10 on pain scale). The pH measurement of the eye with a litmus paper revealed the pH of 7–8 in both eyes. Further examinations revealed bilateral diffuse corneal epithelial loss affecting 80% (approximately) of both corneas. Based on these findings, she was diagnosed with a bilateral chemical eye injury. She was supposed to receive lidocaine/prilocaine around both her eye-lids for the skin treatment; however, some of the cream inadvertently seeped into both her eyes. She felt initial discomfort but it subsided due to anaesthetic effect of the lidocaine/prilocaine. Additionally, the occlusive effect contributed as she had closed her eyes during the therapy resulting in retention of the cream for the treatment duration. Hence, she developed corneal chemical alkaline injury secondary to lidocaine/prilocaine. She also had marked periorbital oedema with multiple dot burn lesions on her skin secondary to plasma fibroblast treatment. The woman was treated with topical chloramphenicol and topical cyclopentolate. Also, she wore soft eye pads over her eyes at night for comfort. The following day, her treatment was switched to preservative free chloramphenicol eye drops along with chloramphenicol ointment. Further, eye examinations 1 day following treatment initiation still revealed a large epithelial defect. The following day her visual acuity was 6/18 in both eyes and she was less photophobic and had resolving bilateral epithelial defects. Subsequently, on day 5, she was prescribed a preservative-free hyaluronic acid [sodium hyaluronate] along with a unspecified paraffin based ointment. On day 5 follow-up, the corneal epithelial defects were mostly resolved; however, a few diffuse punctate erosions were seen in both eyes. Additionally, she had dry eye and mild photophobia and her visual acuity returned to 6/6 in both eyes. At a 25 days follow-up, she reported only mild dry eye symptoms, and her