Treatment of Corneal Abrasion

Topical broad-spectrum antibiotics are the first-line treatment for corneal abrasions to prevent secondary bacterial infection. 1

Initial Management

Apply topical broad-spectrum antibiotics as the primary treatment to prevent bacterial keratitis, especially when treatment is started within 24 hours of the abrasion 2, 1
Fluoroquinolones (such as moxifloxacin or gatifloxacin) are preferred due to their broad-spectrum coverage and FDA approval for bacterial keratitis treatment 1
For non-contact lens wearers with simple abrasions, antibiotic drops alone are typically sufficient 1
Antibiotic ointment may be used at bedtime for additional protection and lubrication 1
Clean the affected area and apply an occlusive dressing that keeps the wound moist and prevents drying 3

More aggressive treatment with frequent antibiotic drops is recommended 2
Avoid eye patching or therapeutic contact lens use due to increased risk of bacterial keratitis 2
Avoid contact lens wear until complete healing is confirmed 2

Over-the-counter oral acetaminophen or NSAIDs for residual discomfort 2
Topical nonsteroidal anti-inflammatory drugs may provide additional pain relief 4

Eye patching is not recommended as it does not improve pain and may delay healing 1, 4
Topical steroids should be avoided initially as they may delay healing and increase infection risk 1
Prophylactic antibiotics are most effective when started within 24 hours of the abrasion 2, 1
Regular follow-up is necessary to monitor healing and detect early signs of infection 2
Most corneal abrasions heal within 24 to 72 hours 4

Do not rub the eye as this can worsen the injury and potentially cause further damage 2, 1
Chronic use of prophylactic antibiotics may promote growth of resistant organisms 2
For central or severe keratitis, more aggressive treatment with frequent antibiotic drops is recommended 2
Patients should be educated about signs and symptoms of infection (increasing pain, purulent discharge, corneal infiltrate) and instructed to seek prompt ophthalmologic care if worsening occurs 2, 1
Inadequate blinking or incomplete eyelid closure can delay healing 1

For patients with corneal abrasions in critical care settings, immediate prophylactic eye care should be initiated to prevent exposure keratitis 3
Artificial-tear ointment is more effective than passive eyelid closure in preventing corneal exposure keratitis 3
For high-velocity eye injuries or penetrating trauma, immediate ophthalmology consultation is required 2