Treatment for Corneal Abrasion That Occurred 5 Days Ago
For a corneal abrasion that occurred 5 days ago, immediate medical attention is recommended if the patient is experiencing persistent foreign-body sensation or symptoms have not improved. 1
Assessment and Immediate Management
- Patients with persistent foreign-body sensation in the eye should seek immediate medical attention, as this may indicate complications or incomplete healing 1
- Do not rub the eye as this can worsen the injury and potentially cause further damage to the corneal epithelium 1
- If symptoms are worsening (increased pain, decreased vision, or signs of infection), urgent ophthalmological evaluation is necessary 2
Treatment Approach
Antibiotic Therapy
- Topical antibiotics should be prescribed to prevent bacterial keratitis, especially if the abrasion was contact lens-related 1, 3
- Broad-spectrum topical antibiotics are preferred over ointments for better corneal penetration 3
- Bacitracin ophthalmic ointment can be used for superficial ocular infections involving the cornea 4
Pain Management
- Over-the-counter oral acetaminophen or NSAIDs are reasonable for treating residual discomfort 1
- Topical NSAIDs may also provide pain relief for persistent symptoms 2
Protective Measures
- Taping a hard plastic eye shield, paper cup, or plastic cup over the eye can help prevent unintentional touching or rubbing 1
- Avoid contact lens wear until complete healing is confirmed by a healthcare professional 1
Special Considerations
- For contact lens wearers, antipseudomonal topical antibiotics are recommended due to higher risk of Pseudomonas infection 2
- Eye patching is not recommended as it does not improve pain and may delay healing 5, 2
- A cycloplegic agent may be considered if substantial anterior chamber inflammation is present 1
Follow-up Recommendations
- If symptoms persist after 5 days, this is considered a delayed healing response and requires ophthalmological evaluation 6
- Potential complications to watch for include:
Warning Signs Requiring Immediate Care
- High-velocity eye injuries or penetrating trauma 1
- Irregular pupil after trauma 1
- Eye bleeding or loss of vision after trauma 1
- Signs of infection (increasing pain, purulent discharge, corneal infiltrate) 1, 2
Most uncomplicated corneal abrasions heal within 24-72 hours 5. An abrasion that has not healed after 5 days may indicate complications requiring specialized ophthalmological care to prevent long-term vision impairment 2, 8.