What are the recommended eyedrop treatments for corneal abrasion?

Corneal Abrasion Eyedrop Treatment

For corneal abrasions, first-line eyedrop treatment should include topical broad-spectrum antibiotics (fluoroquinolones such as moxifloxacin 0.5% or gatifloxacin 0.3%) and topical NSAIDs for pain management. 1

First-Line Treatment Options

Antibiotic Prophylaxis

• Topical broad-spectrum antibiotics are recommended for prophylaxis:
  • Fluoroquinolones (preferred):
    • Moxifloxacin 0.5% - excellent broad-spectrum coverage 1
    • Gatifloxacin 0.3% - broad-spectrum coverage 1
    • Ciprofloxacin 0.3%, Ofloxacin 0.3%, or Levofloxacin 1.5% - for small, non-central ulcers 1
  • For contact lens-related abrasions: Antipseudomonal topical antibiotics are specifically recommended 1, 2

Pain Management

• Topical NSAIDs (e.g., ketorolac 0.5%) - significantly decreases pain, photophobia, and foreign body sensation 3
• Preservative-free artificial tears/lubricants - helps with comfort and healing 1
• Oral analgesics (acetaminophen, NSAIDs) for additional pain control 1

Important Treatment Considerations

What to Avoid

• Eye patching is NOT recommended as multiple studies show it does not improve healing and may actually delay it 1, 4, 2
• Topical cycloplegics are not supported by evidence for uncomplicated corneal abrasions 2
• Oil-based ointments should be avoided in high-risk cases 1

Special Situations

• Deep corneal ulcers (>50% stromal depth) may require surgical intervention if medical therapy fails 1
• For persistent epithelial defects (>2 weeks despite treatment), consider surgical options 1
• High-risk cases benefit from combining eyelid occlusion with preservative-free aqueous lubricants 1

Monitoring and Follow-up

• Most corneal abrasions heal within 24-72 hours 1, 4
• Re-examine every 24 hours until corneal healing occurs 1
• Small (<4mm), uncomplicated abrasions with normal vision and resolving symptoms may not require follow-up 2
• All other patients should be reevaluated in 24 hours 2

Red Flags Requiring Referral

• Symptoms that worsen or don't improve
• Development of corneal infiltrate or ulcer
• Significant vision loss
• Suspicion of penetrating eye injury 2

Prevention

• Recommend protective eyewear for sports and high-risk activities 1
• Avoid overnight wear of contact lenses 1

The most recent guidelines from the American Academy of Ophthalmology strongly support the use of topical antibiotics and NSAIDs while avoiding unnecessary interventions like patching that were once standard practice but have been shown to be ineffective or potentially harmful.