How to manage a simple laceration or abrasion on the nasal bridge caused by eyeglasses?

Management of Simple Abrasions or Lacerations on the Nasal Bridge from Eyeglasses

After cleaning the wound with tap water or soap and water, apply a topical antibiotic ointment (such as bacitracin or neosporin) 1-3 times daily and cover with an occlusive dressing to promote moist wound healing. 1, 2, 3

Immediate Wound Care

Cleaning the Wound

• Irrigate the wound with tap water or soap and water, which is as effective as (or superior to) sterile saline for reducing infection rates in simple traumatic wounds 1
• Use higher volumes (100-1000 mL range) and higher irrigation pressures for optimal cleaning 1
• Body temperature water is more comfortable than cold water if available 1

Wound Dressing

• Apply a small amount of topical antibiotic ointment (equivalent to the surface area of a fingertip) to the cleaned wound 1-3 times daily 2, 3, 2
  • Options include bacitracin or neosporin (triple antibiotic) 2, 3
• Cover with a clean occlusive dressing that keeps the wound moist and prevents drying 1
• This approach significantly shortens healing time compared to leaving wounds open to air 1

Preventing Recurrence: Eyeglass Modification

Immediate Pressure Relief

• Remove direct pressure from the nasal bridge by temporarily elevating eyeglasses off the healing wound 4, 5
• Simple suspension techniques using readily available materials (baseball cap with tie clip or fishing line) can maintain clear vision while avoiding contact with the operative site 5, 6
• Custom eyeglass-holding hooks on snapback caps can be fashioned to prevent nose pads from resting on the nose 6

Long-term Solutions

• Consider hypoallergenic or alternative frame materials if contact dermatitis is suspected 7
• Adjust nose pad positioning or switch to frames with different weight distribution 4
• For patients requiring ongoing eyeglass wear, ensure proper frame fitting to minimize pressure points 7

When to Escalate Care

Red Flags Requiring Medical Evaluation

• Signs of infection: increasing redness, warmth, purulent discharge, or fever 1
• Non-healing wounds after 1-2 weeks of appropriate care 1
• Deep lacerations that may require closure beyond simple first aid 1
• Chronic lesions present for more than one year in the exact location of nose pad pressure, as these may represent malignant transformation (particularly squamous cell carcinoma or basal cell carcinoma in patients wearing glasses for 15+ years) 8

Common Pitfalls to Avoid

• Do not leave superficial abrasions uncovered - occlusive dressings significantly improve healing outcomes 1
• Do not use cold saline when body temperature water is available - it causes unnecessary discomfort 1
• Do not resume wearing eyeglasses with the same pressure points before the wound fully heals - this can delay healing and potentially cause chronic inflammation 4, 8
• Do not dismiss chronic non-healing lesions at eyeglass pressure points as benign, especially in elderly patients with long-term eyeglass use - these warrant dermatologic evaluation 8