From the Guidelines
For a scratched eye, the most effective treatment to prevent infection and promote healing is the use of antibiotic eye drops, such as chloramphenicol ointment 1% three times a day for 3 days, as supported by the Bhaktapur Eye Study 1. When considering treatment options, it's crucial to prioritize the prevention of bacterial keratitis, a major cause of visual disability that can lead to corneal opacification and irregularity 1. The use of chloramphenicol ointment has been shown to be effective in preventing corneal ulcers in patients with corneal abrasions, with only 18 out of 442 patients developing corneal ulcers in the Bhaktapur Eye Study 1. In addition to antibiotic eye drops, preservative-free artificial tears like Refresh, Systane, or TheraTears can be used to lubricate the eye and promote healing, applied 4-6 times daily for comfort and to keep the eye moist. It's also important to note that the use of topical second-generation fluoroquinolones, such as ofloxacin and ciprofloxacin, has been shown to be comparable in efficacy to fortified antibiotics, but no randomized controlled study has been performed to compare their outcomes in severe cases of bacterial keratitis 1. Overall, the key to effective treatment of a scratched eye is prompt evaluation by an eye doctor and the use of antibiotic eye drops to prevent infection, along with proper care and follow-up to prevent complications. Some key points to consider when treating a scratched eye include:
- Applying antibiotic eye drops, such as chloramphenicol ointment 1% three times a day for 3 days
- Using preservative-free artificial tears to lubricate the eye and promote healing
- Avoiding the use of redness-relieving drops like Visine, which can worsen irritation
- Avoiding rubbing the eyes, wearing contact lenses, and using eye makeup while the eye is healing
- Seeking prompt medical evaluation and follow-up care to prevent complications like infection or scarring.
From the Research
Treatment Options for Scratched Eye
- The treatment of corneal injuries, including scratched eyes, may involve the use of several pharmacological agents, such as fluorescein, lissamine green, and rose bengal, to formulate a diagnosis and develop effective treatment strategies 2.
- Analgesic medications, including atropine, cyclopentolate, scopolamine, and homatropine, may be used to help with patient comfort without risking further injury or delaying ocular healing 2.
- Steroidal anti-inflammatory agents, such as prednisolone acetate, loteprednol, difluprednate, dexamethasone, fluorometholone, and methylprednisolone, are frequently used as part of the therapeutic regimen, but side effects must be monitored by clinicians 2.
- Non-steroidal medications, such as ketorolac, bromfenac, nepafenac, and diclofenac, may be used for their efficacy in controlling ocular inflammation without incurring side effects seen with steroids 2.
Eye Drops for Scratched Eye
- Artificial tears may be used as a treatment for corneal abrasions, either alone or in combination with antibiotic ointment 3.
- Topical diclofenac may be used to reduce pain in patients with corneal abrasions 4.
- Antibiotic prophylaxis, such as chloramphenicol or fusidic acid, may be used to prevent infection in corneal abrasions, but the current evidence is insufficient to support any antibiotic regimen being superior to another 5.
Other Treatment Options
- Protection of the ocular surface is a vital component in the treatment of corneal injuries, and temporary protective methods, such as bandage contact lenses and mechanical closure of the eyelids (tarsorrhaphy), may be used in selective cases 2.
- Amniotic membrane therapies (AMTs) and blood-based therapies, including autologous serum tears and plasma-enriched growth factor eyedrops, may be used in challenging and recalcitrant cases 2.