From the Guidelines
Eye abrasions are typically treated with medications that promote healing and prevent infection, with a focus on reducing morbidity, mortality, and improving quality of life. The primary goal of treatment is to prevent infection and promote corneal healing.
- Antibiotic eye drops or ointments, such as erythromycin ointment, polymyxin B/trimethoprim drops, ciprofloxacin drops, or moxifloxacin drops, are commonly prescribed to prevent infection, usually applied 4 times daily for 5-7 days 1.
- For pain management, cycloplegic drops like cyclopentolate 1% or homatropine 5% may be used to reduce pain by temporarily paralyzing eye muscles, typically administered 2-3 times daily for 1-2 days.
- Preservative-free artificial tears can be used frequently to keep the eye lubricated and comfortable.
- Oral pain relievers such as acetaminophen or ibuprofen can help manage discomfort.
- In some cases, a bandage contact lens or amniotic membrane may be used to promote healing, especially in cases of delayed healing 1.
- Cenegermin 20 μg/ml, 6 drops daily for 8 weeks, has shown higher rates of corneal healing than vehicle in patients with neurotrophic keratopathy, and may be considered as an additional treatment option 1. Patients should avoid wearing contact lenses until the abrasion is fully healed and the medication course is complete.
- Eye patches are generally no longer recommended as they may delay healing. Most corneal abrasions heal within 24-72 hours with proper treatment, though larger abrasions may take longer. If symptoms worsen or don't improve within 48 hours, medical attention should be sought as this could indicate complications or infection.
From the Research
Medications for Eye Abrasions
- Topical antibiotics are commonly prescribed to prevent bacterial superinfection in eye abrasions 2
- Topical nonsteroidal anti-inflammatory drugs or oral analgesics may be used for pain relief 2
- Antipseudomonal topical antibiotics are recommended for contact lens-related abrasions 2
- Chloramphenicol and fusidic acid are examples of antibiotics that have been studied for the treatment of corneal abrasions, although the current evidence is insufficient to support any antibiotic regimen being superior to another 3
- The use of topical cycloplegics for uncomplicated corneal abrasions is not supported by evidence 2
Treatment Goals
- Pain control
- Prevention of infection
- Healing of the cornea
- Monitoring for complications, such as corneal infiltrates or ulcers 2, 4
Treatment Options
- Topical antibiotic ointment
- Topical nonsteroidal anti-inflammatory drugs
- Oral analgesics
- Antipseudomonal topical antibiotics (for contact lens-related abrasions)
- Eye patching is not recommended as it does not improve pain and has the potential to delay healing 5