What eyedrops are preferred for treating a corneal abrasion?

Antibiotic Eye Drops for Corneal Abrasion Treatment

For corneal abrasion treatment in a 63-year-old male non-contact lens wearer, a broad-spectrum topical antibiotic eye drop is the preferred treatment to prevent secondary bacterial infection. 1

First-Line Treatment Options

• Topical broad-spectrum antibiotic drops are recommended as they achieve high tissue levels in the cornea and prevent bacterial keratitis 2
• Fluoroquinolones (moxifloxacin or gatifloxacin) are preferred options due to their broad spectrum coverage and FDA approval for bacterial keratitis treatment 2, 3, 4
• Moxifloxacin dosing: Instill one drop in the affected eye 3 times a day for 7 days 3
• Gatifloxacin dosing: Day 1 - one drop every two hours while awake (up to 8 times); Days 2-7 - one drop 2-4 times daily 4

Treatment Algorithm

1. Initial assessment: Confirm diagnosis with fluorescein staining under cobalt-blue filtered light 5
2. Primary treatment: Apply topical antibiotic drops (fluoroquinolones preferred) 2
3. Pain management: Consider topical NSAIDs for pain relief 6
4. Adjunctive therapy: Antibiotic ointment may be used at bedtime for additional protection 2

Important Considerations

• Do not patch the eye - Studies show patching does not improve healing and may actually hinder it 1, 5
• Avoid topical steroids initially as they may delay healing and increase infection risk 7
• Monitor for healing - Most corneal abrasions heal within 24-72 hours 5
• Warning signs requiring immediate follow-up: increasing pain, purulent discharge, or corneal infiltrate 2

Special Considerations for Non-Contact Lens Wearers

• For non-contact lens wearers with simple abrasions, antibiotic drops alone are typically sufficient 2
• The choice of antibiotic should consider the normal flora of the skin, eyelid margin, and conjunctiva 1
• For older patients, consider underlying medical conditions (e.g., diabetes) that may affect healing 1

Alternative or Adjunctive Treatments

• Bandage contact lens may be helpful in cases of delayed healing but is generally not needed for simple abrasions 1
• Amniotic membrane may be considered for persistent defects but is not indicated for routine corneal abrasions 1
• Oral analgesics can be used as needed for discomfort 6

Pitfalls to Avoid

• Chronic use of prophylactic antibiotics may promote resistant organisms 2
• Inadequate blinking or incomplete eyelid closure can delay healing 1
• Rubbing the eye can worsen the injury and potentially cause further damage 2