From the Guidelines
For an eye abrasion, topical antibiotics should be prescribed to prevent acute bacterial keratitis, especially in patients who wear contact lenses or have suffered trauma, as this helps prevent not only bacterial infection but also fungal infection. The treatment of eye abrasion involves several steps to promote healing and prevent infection. Firstly, rinse the eye gently with clean water or saline solution to remove any debris 1. Apply lubricating eye drops or artificial tears several times daily to keep the eye moist and promote healing. Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage discomfort. Avoid rubbing the eye and consider wearing sunglasses to reduce light sensitivity. For the first 24 hours, a cold compress applied for 5-10 minutes several times daily can reduce swelling and pain.
Medical attention is necessary if the abrasion is severe, caused by chemicals or foreign objects, or if symptoms worsen. A doctor may prescribe antibiotic eye drops like erythromycin or ciprofloxacin to prevent infection, typically used 4 times daily for 5-7 days 1. They might also recommend a topical pain reliever or cycloplegic drops to reduce pain and spasm. It is essential to note that patching the eye or using a therapeutic contact lens is not advised in patients with contact-lens associated abrasion due to concerns for increased risk of secondary bacterial keratitis 1. Eye abrasions typically heal within 1-3 days as the cornea has remarkable regenerative abilities, with cells rapidly multiplying to repair the damaged surface.
Key considerations in the treatment of eye abrasion include:
- Preventing infection with topical antibiotics, especially in high-risk patients 1
- Promoting healing with lubricating eye drops and avoiding irritants
- Managing pain and discomfort with over-the-counter pain relievers and cold compresses
- Seeking medical attention if symptoms worsen or if the abrasion is severe 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 FDA drug label does not answer the question.
From the Research
Treatment Options for Eye Abrasion
- The primary goal of treatment is to manage symptoms, such as pain, tearing, and photophobia, and to prevent infection 2.
- Topical nonsteroidal anti-inflammatory drugs (NSAIDs) or oral analgesics can be used to relieve pain and discomfort 2.
- Topical antibiotics may also be used to prevent infection, although the evidence for their effectiveness is limited 3.
- Eye patching is not recommended, as it may hinder healing and is not supported by well-designed studies 2.
Antibiotic Prophylaxis
- The use of antibiotic prophylaxis in corneal abrasion is still a topic of debate, with limited evidence to support its effectiveness 3.
- A review of randomized controlled trials found that the evidence for antibiotic prophylaxis in preventing ocular infection or accelerating epithelial healing is of low to very low certainty 3.
- Different antibiotic regimens have been compared, but the current evidence is insufficient to support any one regimen as superior to another 3, 4.
Prevention and Management
- Corneal abrasions can be prevented through the use of protective eyewear 2.
- In cases where corneal abrasion occurs, prompt treatment and close monitoring are essential to prevent complications and promote healing 5.
- Updated guidelines for prevention and management of perioperative corneal abrasion emphasize the importance of pain control, antimicrobial prophylaxis, and close monitoring 5.