What eye drops are recommended for treating eye trauma?

Eye Drops for Eye Trauma

For eye trauma, the recommended eye drops include ocular lubricants (nonpreserved hyaluronate or carmellose), topical antibiotics (moxifloxacin), and topical corticosteroids (nonpreserved dexamethasone 0.1%), with selection based on the specific type and severity of trauma. 1

Initial Management of Eye Trauma

• Patients with high-velocity eye injuries (grinding, nailing, machinery), penetrating eye injuries from sharp objects, irregular pupil after trauma, eye bleeding, or vision loss after trauma should seek immediate medical attention 1
• Do not rub the eye as this can worsen the injury and potentially cause further damage to the corneal epithelium 1
• Taping a hard plastic eye shield, paper cup, or plastic cup over the eye can help prevent unintentional touching or rubbing of the eye 1, 2

Recommended Eye Drops Based on Type of Trauma

For General Eye Trauma:

• Ocular Lubricants: Apply nonpreserved hyaluronate or carmellose eye drops every 2 hours during the acute phase to maintain corneal epithelial integrity 1
• Topical Antibiotics: Administer broad-spectrum topical antibiotics (e.g., moxifloxacin drops four times daily) in the presence of corneal fluorescein staining or frank ulceration 1
• Dosage: For moxifloxacin, instill one drop in the affected eye 3 times a day for 7 days 3

For Corneal Abrasions:

• Topical Antibiotics: Broad-spectrum topical antibiotics should be prescribed to prevent bacterial keratitis, especially when treatment is started within 24 hours of the abrasion 2
• Fluoroquinolones: For central or severe keratitis, more aggressive treatment with frequent antibiotic drops (fluoroquinolones) is recommended 2
• Pain Management: Over-the-counter oral acetaminophen or NSAIDs are reasonable for treating residual discomfort 1, 2

For Inflammatory Eye Trauma:

• Topical Corticosteroids: Application of topical corticosteroid drops (e.g., nonpreserved dexamethasone 0.1% twice daily) may reduce ocular surface damage in the acute phase 1
• Caution: Topical corticosteroids should be used with caution in the presence of a corneal epithelial defect as they can mask the signs of corneal infection 1

Special Considerations

• Contact Lens Wearers: For patients who wear contact lenses and present with corneal trauma, topical antibiotics should be prescribed to prevent acute bacterial keratitis 2
• Timing of Treatment: Early administration of antibiotics is crucial in preventing infection in penetrating eye injuries 4
• Unconscious Patients: In unconscious patients, prevention of corneal exposure is essential to reduce the risk of ulceration and infection 1

Monitoring and Follow-up

• Daily ophthalmological review is necessary during the acute illness 1
• Ocular hygiene, to remove inflammatory debris and break down conjunctival adhesions, must be carried out each day by an ophthalmologist or ophthalmically trained nurse 1
• Regular follow-up is necessary to monitor healing and detect early signs of infection 2

Common Pitfalls and Caveats

• Avoid patching the eye in contact lens wearers due to increased risk of secondary bacterial keratitis 2
• Chronic use of prophylactic antibiotics may promote growth of resistant organisms 2
• Potentially severe injuries can be harbored in the recesses of the angle or far periphery of the retina, so thorough examination is essential 5
• Even if one eye has more obvious signs of injury, always examine the fellow eye as less severe trauma may have resulted in serious injuries that can go undetected 5