From the Guidelines
For corneal abrasions, broad-spectrum topical antibiotic eye drops should be prescribed to prevent acute bacterial keratitis, especially in patients who wear contact lenses or have experienced trauma. This approach helps prevent not only bacterial infection but also fungal infection 1. The use of prophylactic topical antibiotics in this setting has been shown to prevent ulceration when treatment is started within 24 hours of the abrasion 1.
Key Considerations
- Topical antibiotics should be applied to prevent infection, with options including broad-spectrum antibiotics 1
- Patients with contact-lens associated abrasion should avoid patching the eye or using a therapeutic contact lens due to concerns for increased risk of secondary bacterial keratitis 1
- Lubricating artificial tears can help with comfort and healing, and should be applied as needed
- Patients should avoid wearing contact lenses until the abrasion is fully healed and the medication course is complete
Treatment Approach
- Broad-spectrum topical antibiotic eye drops should be prescribed for 5-7 days to prevent infection
- Pain management may include cycloplegic drops to reduce pain from ciliary muscle spasm
- Topical anesthetics should never be prescribed for home use as they can delay healing and potentially cause further damage
- Most corneal abrasions heal within 24-72 hours with proper treatment, and patients should seek immediate follow-up care if symptoms worsen or don't improve within 48 hours 1
From the Research
Corneal Abrasion Eye Drops
- Corneal abrasions are injuries that result from cutting, scratching, or abrading the thin, protective, clear coat of the exposed anterior portion of the ocular epithelium 2.
- Symptoms of corneal abrasions can be worsened by exposure to light, blinking, and rubbing the injured surface against the inside of the eyelid 2.
- Initial treatment for corneal abrasions should be symptomatic, consisting of foreign body removal and analgesia with topical nonsteroidal anti-inflammatory drugs or oral analgesics; topical antibiotics may also be used 2.
Treatment Options
- Topical mydriatics are not beneficial in the treatment of corneal abrasions 2.
- Eye patching traditionally has been recommended in the treatment of corneal abrasions, but multiple well-designed studies show that patching does not help and may hinder healing 2.
- The use of soft contact lenses and topical diclofenac has been shown to provide significant pain relief and promote healing of corneal abrasions 3, 4.
- Antibiotic prophylaxis may be used in the treatment of corneal abrasions, but the current evidence is insufficient to support any antibiotic regimen being superior to another 5.
Management and Prevention
- Corneal abrasions can be avoided through the use of protective eyewear 2.
- Treatment of traumatic corneal abrasion with a contact lens associated with topical NSAID drops and antibiotic drops can reduce pain and allow patients to return to their normal activities 4.
- Updated guidelines for the prevention and management of perioperative corneal abrasion recommend pain control, antimicrobial prophylaxis, and close monitoring 6.