From the Research
Traumatic iritis in the emergency department is typically not treated with antibiotics as it is an inflammatory condition rather than an infectious one. The standard treatment involves topical corticosteroids such as prednisolone acetate 1% eye drops, administered 4-6 times daily, along with a cycloplegic agent like cyclopentolate 1% or homatropine 2-5% eye drops 2-3 times daily. The corticosteroids reduce inflammation while the cycloplegic provides pain relief by paralyzing the ciliary muscle and preventing pupillary movement. Treatment duration is usually 1-2 weeks with gradual tapering based on clinical improvement. Antibiotics would only be indicated if there is a corneal abrasion or laceration with risk of infection, in which case fluoroquinolones like moxifloxacin 0.5% or gatifloxacin 0.3% eye drops would be used 4 times daily, as supported by studies such as 1 and 2. It's essential to note that patients should be referred to an ophthalmologist for follow-up within 24-48 hours, and should be advised to avoid rubbing the eye and to wear protective eyewear to prevent further trauma, as highlighted in 3 and 4. The most recent and highest quality study 3 provides valuable insights into the incidence, mechanisms, and clinical characteristics of traumatic iritis, which can guide treatment decisions and improve patient outcomes. Key considerations in managing traumatic iritis include:
- Topical corticosteroids and cycloplegic agents as first-line treatment
- Antibiotics only in cases with high risk of infection
- Prompt referral to an ophthalmologist
- Patient education on preventing further trauma and promoting recovery.