From the Guidelines
For corneal abrasions, broad-spectrum topical antibiotic eye drops, such as fluoroquinolones like ciprofloxacin or moxifloxacin, are recommended to prevent infection while the cornea heals, as stated in the most recent study 1. The goal of treatment is to promote healing, prevent infection, and minimize complications.
- Commonly prescribed options include erythromycin ointment, polymyxin B/trimethoprim drops, or fluoroquinolones like ciprofloxacin or moxifloxacin.
- These are usually applied 4 times daily for 5-7 days.
- Pain management may include cycloplegic drops like cyclopentolate 1% or homatropine 5% to reduce pain from ciliary muscle spasm, typically used 2-3 times daily for 1-2 days.
- Lubricating artificial tears can also help with comfort and healing, applied every 2-4 hours as needed.
- Patients should avoid wearing contact lenses until the abrasion is fully healed and the medication course is complete.
- It's essential to note that topical anesthetics (like proparacaine) should never be prescribed for home use as they can delay healing and mask worsening symptoms, as mentioned in 1. Most corneal abrasions heal within 24-72 hours with proper treatment.
- If symptoms worsen or don't improve within 48 hours, patients should seek immediate re-evaluation to rule out infection or other complications.
- The use of prophylactic topical antibiotics following corneal abrasion has been shown to prevent ulceration when treatment is started within 24 hours of the abrasion, as stated in 1.
- In patients with contact-lens associated abrasion, patching the eye or using a therapeutic contact lens is not advised due to concerns for increased risk of secondary bacterial keratitis, as mentioned in 1.
From the Research
Recommended Eye Drops for Corneal Abrasion
The following are some of the recommended eye drops for treating corneal abrasion:
- Moxifloxacin HCl (0.5% w/v) eye drops, which are one of the most widely used treatments for corneal abrasion 2
- Chloramphenicol ocular ointment, which has been compared to fusidic acid ocular gels in a study, but the evidence is of very low certainty 3
- Ketorolac trometamol 0.5% ophthalmic solution, which may be a useful adjunct in the management of corneal abrasions, as it reduces the need for additional oral analgesics 4
- Diclofenac (Voltaren) eye drops, which have been used in combination with disposable soft contact lenses and antibiotic eye drops to treat corneal abrasions, providing significant pain relief and promoting healing within 3 days 5
Key Findings
- Topical nonsteroidal anti-inflammatory drugs (NSAIDs) such as ketorolac and diclofenac may be beneficial in reducing pain and discomfort associated with corneal abrasions 4, 5
- Antibiotic prophylaxis may be used to prevent infection, but the current evidence is insufficient to support any specific antibiotic regimen 3
- The use of eye patches is not recommended, as it may hinder healing 6