|Home | About | Journals | Submit | Contact Us | Français|
What is the best treatment for traumatic corneal abrasion?
Eye patching does not reduce pain in patients with corneal abrasions. Topical diclofenac does reduce pain in patients with corneal abrasions
Pitfalls to avoid when treating abrasions:
A corneal abrasion is a defect in the corneal epithelial surface. Etiology: Usually traumatic – but can occur spontaneously, eg, dry eyes, neurotrophic eyes.
One study suggests that over 10% of new presentations at eye accident departments are for traumatic corneal abrasion.1
No published study has addressed the economic issues of corneal abrasion. These would include the frequency of presentation to eye departments, time off work and cost of medications to the (usually younger) individuals.
Systematic reviews, meta-analyses, RCTs.
PubMed, Cochrane Library, NHS evidence, DARE, clinical evidence.
From the patient perspective the main outcomes:
A corneal abrasion is a scratch of the surface of the eye. It is usually caused accidentally, eg, a fingernail, contact lens. It is very painful immediately and medical attention should be sought. There is good evidence that a combination of drops is the quickest and most comfortable way to make the abrasion heal.
|Randomized controlled trials:||5|
The Systematic Review2 concluded that ‘Treating simple corneal abrasions with a patch does not improve healing rates on the first day post-injury. In addition, use of patches results in a loss of binocular vision’.
The meta-analysis3 stated ‘Eye patching was not found to improve healing rates in patients with corneal abrasions’
Randomized trials – see table below. The studies generally found that padding the eye either made no difference to the rate of healing or that topical antibiotic and cycloplegia led to faster healing of the abrasion.
Use a topical antibiotic and cycloplegic for traumatic corneal abrasions.
|Randomized controlled trials:||7|
The Systematic Review2 concluded ‘Treating simple corneal abrasions with a patch does not reduce pain’.
The meta-analysis3 concluded ‘Eye patching was not found to reduce pain in patients with corneal abrasions’. As far as the drop regime is concerned the interventions were variable so no specific regime was recommended.
RCTs – see Table 2. The studies generally found that padding the eye either made no difference to reported pain or in one study was more painful. Two studies indicate that topic diclofenac relieves abrasion pain more than placebo.
Eye patching does not reduce pain in patients with corneal abrasions.
Topical diclofenac does reduce pain in patients with corneal abrasions.
See separate topic.
Corneal abrasion can be managed by non-specialists. Indications for specialist referral are given below.
Small abrasions with moderate pain
Bandage contact lenses should only be used in specialist departments and in those with experience of their use.