From the Guidelines
The most appropriate treatment for eye trauma is immediate irrigation with a copious amount of water for at least 15 minutes, or until advanced medical care arrives, especially in cases of chemical exposure, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. For minor eye injuries like foreign bodies or minor scratches, gently flushing the eye with clean water or saline solution is recommended.
- Do not rub the eye.
- For chemical exposures, immediate irrigation with water for 15-20 minutes is crucial.
- For blunt trauma causing pain or swelling, apply a cold compress without pressure for 10-15 minutes.
- If there's a penetrating injury or embedded object, do not attempt removal; instead, cover the eye loosely with a clean shield (like a paper cup) and seek emergency care immediately.
- For corneal abrasions, antibiotic eye drops like erythromycin or ciprofloxacin may be prescribed, typically 1-2 drops 4 times daily for 5-7 days, as suggested by the bacterial keratitis preferred practice pattern 1. Pain management may include oral analgesics and cycloplegic eye drops like cyclopentolate to reduce painful ciliary muscle spasms. Any eye injury involving vision changes, severe pain, bleeding, pupil irregularities, or protruding objects requires immediate professional evaluation. Prompt treatment is essential as delays can lead to permanent vision loss, especially with chemical injuries where each minute counts in preventing corneal damage. It is also important to note that the use of a commercial eye irrigation solution may be more effective than other irrigation fluids, as demonstrated in the 2024 American Heart Association and American Red Cross guidelines for first aid 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 for Eye Trauma
The treatment for eye trauma depends on the type and severity of the injury. According to 2, a detailed history and complete ocular examination are crucial in assessing the extent of the injury. The following are some common treatments for eye trauma:
- Corneal abrasions: Treatment consists of applying a cycloplegic medication, antibiotic ointment, and a patch (unless a corneal ulcer is suspected) 3.
- Iritis: Can be treated with cycloplegics and topical corticosteroids 3.
- Hyphemas: Treated with bed rest, topical atropine sulfate drops, and topical corticosteroids, as well as measures to prevent rebleeding 3.
- Acid and alkali burns: Should be irrigated until the pH is normal and then treated like a corneal abrasion 3.
- Lid lacerations: Must be repaired with care to preserve proper functioning of the lid 3.
- Ruptures of the globe: Are serious injuries requiring surgical repair and long-term follow-up 3, 4.
Specific Treatments
Some studies have investigated specific treatments for eye trauma, including:
- Eye patching for traumatic corneal abrasions: A controlled clinical trial found that eye patching does not appear to be beneficial in the treatment of traumatic corneal abrasions compared with topical antibiotic ointment 5.
- Topical antibiotics: Most respondents in a national survey prescribed topical antibiotics, particularly for contact lens wearers and patients with ocular foreign bodies 6.
- Pain management: Preferences included oral analgesics, cycloplegics, and topical non-steroidal anti-inflammatory drugs (NSAIDs) 6.
Examination and Referral
A thorough knowledge of potential injuries is imperative to ensure rapid diagnosis, to prevent further damage to the eye, and to preserve visual capacity 4. A structured approach to the history and examination is provided in 2, and the aim is to enhance clinician confidence when encountering patients with eye trauma. Accurate history-taking and astute observation are paramount for timely treatment or referral that may prevent blindness 2.