Adverse drug reactions are potentially serious and are becoming increasingly common. Although optometrists employ only a limited spectrum of drugs they may encounter such reactions among their patients. There is always a risk that a life threatening situation will develop in a patient quite apart from the use of any drugs. An optometrist as a member of the health-care team must be competent to provide first-aid if an emergency occurs.Tables are provided listing possible reactions to topical anesthetics with the usual signs and the preferred treatment.Optometrists are reminded that many of these treatments are the responsibility of physicians. Optometrists should be prepared to provide artificial respiration and external cardiac massage and should plan in advance how they will obtain additional assistance if an emergency occurs in their office.