From the Guidelines
For corneal abrasions in contact lens wearers, ofloxacin eye drops (0.3%) should be administered 1-2 drops every 2-4 hours while awake for the first two days, then decreasing to 1-2 drops four times daily until the abrasion heals (typically 5-7 days total). This recommendation is based on the most recent guidelines for bacterial keratitis treatment, which suggest that topical antibiotic eye drops are the preferred method of treatment in most cases 1. The frequent initial dosing ensures adequate antimicrobial concentration on the ocular surface, while the tapered schedule maintains protection while allowing healing.
Key Considerations
- Contact lens wear should be completely discontinued until the abrasion fully heals and the antibiotic course is completed, as contact lens wearers have a higher risk of developing Pseudomonas or other gram-negative infections, which can rapidly progress to sight-threatening conditions.
- Ofloxacin provides broad-spectrum coverage against these potential pathogens, although it is essential to note that some pathogens, such as Streptococci and anaerobes, may have variable susceptibility to fluoroquinolones, and the prevalence of resistance to fluoroquinolones appears to be increasing 1.
- Patients should be advised to store the drops properly, avoid touching the dropper tip to prevent contamination, and return for follow-up within 24-48 hours to assess healing.
- If symptoms worsen (increased pain, decreased vision, purulent discharge), immediate re-evaluation is necessary.
Treatment Rationale
- The use of ocular ointments is not recommended as the primary treatment due to their lack of solubility and limited ability to penetrate the cornea for optimum therapeutic benefit 1.
- Subconjunctival antibiotic injections or systemic therapy may be considered in severe cases, such as central or severe keratitis, or in cases of scleral or intraocular extension of infection 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Frequency and Dosing of Ofloxacillin Eye Drop for Corneal Abrasion
- The frequency and dosing of ofloxacillin eye drops for corneal abrasion in a patient who wears contact lenses is not directly addressed in the provided studies 2, 3, 4, 5, 6.
- However, a study comparing different treatment modalities for traumatic corneal abrasions found that ofloxacin ointment alone, pressure patching with ofloxacin ointment, and therapeutic contact lens with ofloxacin eye drops were equally effective in reducing abrasion area and pain 3.
- Another study evaluated the treatment of traumatic corneal abrasions with therapeutic soft contact lenses in association with NSAID and antibiotic drops, and found that this regimen was safe, effective, and comfortable for patients 4.
- A study on the clinical efficacy of moxifloxacin in the treatment of bacterial keratitis found that moxifloxacin, ofloxacin, and fortified tobramycin/cephazolin had similar healing rates and cure rates, and were safe and well-tolerated 5.
- A review of corneal abrasion treatment found that topical diclofenac reduces pain in patients with corneal abrasions, but eye patching does not reduce pain 6.
Treatment Considerations for Contact Lens Wearers
- When treating corneal abrasions in contact lens wearers, it is essential to consider the risk of infection and the potential for complications 2, 3, 4, 5, 6.
- The use of antibiotic eye drops, such as ofloxacin, may be beneficial in preventing infection and promoting healing 3, 4, 5.
- However, the frequency and dosing of ofloxacillin eye drops specifically for corneal abrasion in contact lens wearers is not well-established in the provided studies 2, 3, 4, 5, 6.