Cornea specialists are the highest opioid prescribers at a large academic eye institute in the USA.

Background/aim: To evaluate the opioid prescription patterns across ophthalmic subspecialties at a large academic eye centre.

Methods: A single site, retrospective cross-sectional study. Electronic medical records from the year 2018 were screened. Ophthalmology patients ≥18 years of age were included. The main outcome measures were patient demographics, outpatient opioid prescriptions, ophthalmic procedure and prescriber details, including department and training level.

Results: 1654 opioid prescriptions were written, accounting for 2.2% of all ophthalmic procedures in a calendar year. Of the patients who received prescriptions, 51.4% were female (n=851) with a mean age of 52.3±18.5 (range 18-95 years). In general, the morphine equivalent dose was low, with an average of 12.4±6.75 pills dispensed (range 1-60) with 0.0±0.01 refills (range 0-3). Cornea specialists were the highest opioid prescribers (22.7% of all providers who wrote a prescription), followed by oculoplastics (22.2%) and retina (18.4%). The most common procedure for which an opioid was prescribed was cornea crosslinking (14.3% of all opioid prescriptions).

Conclusions: While opioid prescriptions are generally low for ophthalmic procedures across departments, cornea specialists accounted for nearly a third of opioid prescriptions. Over half of corneal crosslinking patients received opioid prescriptions; there remains an unmet need for opioid-sparing therapy for these patients and others with severe eye pain.