From the Guidelines
For an 8-year-old child with a corneal abrasion, I recommend a treatment plan that includes lubricating artificial tears (preservative-free) every 2-4 hours while awake, and antibiotic eye drops such as erythromycin ophthalmic ointment or trimethoprim/polymyxin B drops 4 times daily for 5-7 days to prevent infection, as suggested by the most recent guidelines 1. The child should avoid rubbing the eye and may benefit from cool compresses for 10-15 minutes several times daily to reduce discomfort. Oral acetaminophen (10-15 mg/kg every 4-6 hours) or ibuprofen (10 mg/kg every 6-8 hours) can be given for pain management, as these are common practices in pediatric care. Parents should be educated that corneal abrasions typically heal within 1-3 days, but they should seek immediate medical attention if the child develops increased pain, worsening redness, yellow or green discharge, vision changes, or if symptoms don't improve within 48 hours. Prevention education is also important - teach the child to avoid touching or rubbing eyes with dirty hands, wear protective eyewear during sports or activities with risk of eye injury, and be cautious with pointed objects. It's worth noting that the use of corticosteroids may be considered after 48 hours of antibiotic therapy when the causative organism is identified and/or the infection has responded to therapy, but this should be done with caution and under the guidance of a healthcare professional 1. Additionally, patching the eye is not advised in patients with a corneal abrasion who wear contact lenses or suffered trauma, as it increases the risk of secondary bacterial keratitis 1.
From the FDA Drug Label
For the treatment of superficial ocular infections involving the conjunctiva and/or cornea caused by organisms susceptible to erythromycin. In the treatment of superficial ocular infections, erythromycin ophthalmic ointment approximately 1 cm in length should be applied directly to the infected eye(s) up to six times daily, depending on the severity of the infection.
The treatment plan for an 8-year-old child with a corneal (conjunctival) abrasion may include topical antibiotic treatment, such as erythromycin ophthalmic ointment, applied up to six times daily. However, the provided drug labels do not explicitly address the treatment of corneal abrasions, but rather superficial ocular infections. Therefore, the treatment plan should be determined by a healthcare professional on a case-by-case basis, considering the severity of the abrasion and potential for infection 2 2.
From the Research
Treatment Plan for Corneal Abrasion in an 8-Year-Old Child
- The treatment plan for an 8-year-old child with a corneal (conjunctival) abrasion may involve the use of topical antibiotic ointment, as suggested by 3.
- However, the evidence from 3 also indicates that the current evidence is insufficient to support any antibiotic regimen being superior to another, and the beneficial effects of antibiotic prophylaxis in preventing ocular infection or accelerating epithelial healing remain unclear.
- An alternative treatment approach, as reported in 4, involves the use of a disposable soft contact lens and instillation of diclofenac and antibiotic eye drops, which provided significant pain relief and allowed for rapid healing of the abrasion.
- Another study, 5, found that eye patching does not appear to be beneficial in the treatment of traumatic corneal abrasions compared to topical antibiotic ointment.
- In cases of conjunctivitis, which may be related to corneal abrasion, 6 suggests that antibiotic eye drops may not be necessary unless eye washing is ineffective, and that waiting to see how symptoms evolve before prescribing local antibiotics may be a reasonable approach.
Considerations for Treatment
- The treatment plan should be individualized based on the specific needs and circumstances of the child, including the size and location of the abrasion, the presence of any underlying medical conditions, and the child's overall health status.
- Topical antibiotic ointment may be used to prevent infection, but the choice of antibiotic and the duration of treatment should be guided by the results of 3 and other relevant studies.
- Pain management is an important aspect of treatment, and the use of diclofenac eye drops, as reported in 4, may be considered as an adjunct to other treatments.