What is the treatment for a corneal abrasion (scratched cornea)?

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From the Guidelines

Treatment for a scratched cornea typically involves applying Cenegermin 20 μg/ml 6 drops daily for 8 weeks, as it has shown higher rates of corneal healing compared to vehicle 1. When it comes to managing a scratched cornea, the primary goal is to promote healing, prevent infection, and minimize the risk of complications.

  • Antibiotic eye drops may be prescribed to prevent infection, although the most recent evidence suggests that Cenegermin may be a more effective option for promoting corneal healing 1.
  • Pain management is also crucial, and this can be achieved through the use of lubricating eye drops and oral pain relievers such as acetaminophen or ibuprofen.
  • In some cases, a bandage contact lens may be applied to protect the eye and promote healing, especially if there is a significant defect or thinning of the cornea 1.
  • It is essential to avoid wearing contact lenses until the cornea is fully healed and to avoid rubbing the eyes, as this can exacerbate the injury and lead to further complications.
  • The use of amniotic membranes, either as an onlay or inlay, has also been shown to promote healing by releasing anti-inflammatory and prohealing mediators 1.
  • In cases of progressive thinning or small perforation, structural support with a tissue adhesive may be necessary, and a small area of marked thinning or early descemetocele may be coated with a thin layer of adhesive 1.
  • Regular follow-up with an ophthalmologist is crucial to monitor the healing process and address any potential complications promptly.
  • If you experience worsening pain, decreased vision, or increased redness, seek immediate medical attention as these could indicate complications like infection. The cornea has remarkable healing abilities due to its rich nerve supply and epithelial cells that rapidly regenerate, but proper treatment is essential to prevent scarring that could permanently affect vision 1.

From the FDA Drug Label

INDICATIONS AND USAGE: For the treatment of superficial ocular infections involving the conjunctiva and/or cornea caused by Bacitracin susceptible organisms. The answer to scratched cornea treatment is not directly provided, as the label only mentions treatment of superficial ocular infections. Bacitracin (OPHTH) may be used for treating infections of the cornea, but it does not explicitly state it is for treating a scratched cornea 2.

From the Research

Treatment Options for Scratched Cornea

  • The treatment of corneal abrasions should be symptomatic, consisting of foreign body removal and analgesia with topical nonsteroidal anti-inflammatory drugs or oral analgesics 3
  • Topical antibiotics may also be used in the treatment of corneal abrasions, although the current evidence is insufficient to support any antibiotic regimen being superior to another 4
  • Topical NSAIDs have been shown to reduce pain scores at 24 and 48 hours, as well as reduce the need for oral analgesia 5
  • Pressure patching has been found to be ineffective at pain reduction and may increase the risk of complications 5, 6

Healing Time and Complications

  • Most corneal abrasions heal in 24 to 72 hours and rarely progress to corneal erosion or infection 3
  • The epithelium was found to be healed in all patients at day 7 in a study comparing three different treatment modalities for traumatic corneal abrasions 6
  • Persistent, worsening, or new symptoms warrant immediate specialist consultation 7

Prevention

  • Corneal abrasions can be avoided through the use of protective eyewear 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Management of corneal abrasions.

American family physician, 2004

Research

Antibiotic prophylaxis for corneal abrasion.

The Cochrane database of systematic reviews, 2022

Research

Topical pain control for corneal abrasions: A systematic review and meta-analysis.

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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