The management of a corneal abrasion involves both pharmacologic and nonpharmacologic interventions, aimed at promoting healing, preventing infection, and alleviating pain.
Pharmacologic interventions
- Topical NSAIDs: Topical NSAIDs such as diclofenac 0.1% are recommended for their analgesic and anti-inflammatory properties
- Systemic analgesics: Systemic analgesics such as ibuprofen or acetaminophen are recommended for the first 24 hours if necessary
- Topical anesthetics: Topical anesthetics such as proxymetacaine 0.5% or oxybuprocaine 0.4% may aid examination if necessary. However, they are not recommended for long-term use due to potential epithelial toxicity, delayed healing, and symptom masking
- Cycloplegics and mydriatics: Cycloplegics such as cyclopentolate 1% BID until healed are considered for large corneal abrasions or associated iritis . However, they are not recommended for uncomplicated corneal abrasions
- Topical antibiotics: Topical antibiotics help prevent bacterial superinfection. A broad-spectrum topical antibiotic such as chloramphenicol 0.5% is recommended if there is a possibility of infection. In contact lens wearers, antibiotic prophylaxis with an agent effective against Gram-negative organisms, such as a quinolone (levofloxacin or moxifloxacin) or an aminoglycoside (gentamicin), is recommended. Contact lens use should be avoided during the treatment period
Nonpharmacologic interventions
- Eye patching: Eye patching is generally not recommended as it may not improve healing or reduce pain, and it may delay healing
- Therapeutic contact lenses: There is insufficient evidence to support the use of bandage contact lenses in the management of corneal abrasions
- Eye protection: Wearing sunglasses is recommended to protect the eye
In conclusion, the management of corneal abrasion involves a combination of pharmacologic and nonpharmacologic interventions tailored to the specific needs of the patient. The goal is to promote healing, prevent infection, and manage pain effectively.