Treatment of Corneal Abrasion

Initial Management

Topical broad-spectrum antibiotics are the first-line treatment for corneal abrasions to prevent secondary bacterial infection, especially when treatment is started within 24 hours of the abrasion 1, 2
Fluoroquinolones, such as moxifloxacin or gatifloxacin, are preferred due to their broad-spectrum coverage and FDA approval for bacterial keratitis treatment 1
For non-contact lens wearers with simple abrasions, antibiotic drops alone are typically sufficient 1
Antibiotic ointment may be used at bedtime for additional protection and lubrication 1
Cleaning the affected area and applying an occlusive dressing that keeps the wound moist and prevents drying is recommended 3

For simple non-contact lens related abrasions, apply topical antibiotic drops 4 times daily 1
Consider antibiotic ointment at bedtime for additional protection in simple non-contact lens related abrasions 1
Oral analgesics such as acetaminophen or NSAIDs can be used for pain control in simple non-contact lens related abrasions 1
More aggressive treatment with frequent antibiotic drops is recommended for contact lens related abrasions 2
Avoid eye patching or therapeutic contact lens use due to increased risk of bacterial keratitis in contact lens related abrasions 2
Avoid contact lens wear until complete healing is confirmed in contact lens related abrasions 2

Over-the-counter oral acetaminophen or NSAIDs can be used for residual discomfort 2

Eye patching is not recommended as it does not improve pain and may delay healing 1
Topical steroids should be avoided initially as they may delay healing and increase infection risk 1
Prophylactic antibiotics are most effective when started within 24 hours of the abrasion 1, 2
Regular follow-up is necessary to monitor healing and detect early signs of infection 2

Do not rub the eye as this can worsen the injury and potentially cause further damage 1, 2
Chronic use of prophylactic antibiotics may promote growth of resistant organisms 2
For central or severe keratitis, more aggressive treatment with frequent antibiotic drops is recommended 2
Patients should be educated about signs and symptoms of infection and instructed to seek prompt ophthalmologic care if worsening occurs 1, 2
Inadequate blinking or incomplete eyelid closure can delay healing 1

For patients with corneal abrasions in critical care settings, immediate prophylactic eye care should be initiated to prevent exposure keratitis 4
Artificial-tear ointment is more effective than passive eyelid closure in preventing corneal exposure keratitis 4
For high-velocity eye injuries or penetrating trauma, immediate ophthalmology consultation is required 2