• Topical chloramphenicol prevents secondary infection of corneal abrasions.

• Although topical anaesthetic agents may be used to aid examination and relieve the pain of a corneal abrasion, they should not be prescribed for patients to use for pain relief at home. This is because they delay wound healing and increase the risk of corneal ulcer formation. Recent evidence suggests no additional benefit with the use of topical mydriatics and they should no longer be used in routine management of corneal abrasion. Using an eye patch is also not recommended as patching results in an acute loss of binocular vision that impacts on driving, work and other day to day activities.

Foreign body

• Local anaesthetic eye drops act for about 15 minutes, so an eye pad to prevent injury is not required. In primary care oral paracetamol or ibuprofen is to be preferred to topical NSAIDs.

• Do not replace the contact lenses until 24 hours after the antibiotic course has been completed. 

• Current guidance also recommends a discussion with an ophthalmologist in view of the history of contact lens use. It would be recommended to re-examine after 24 hours using fluorescein stain, to ensure the corneal abrasion is healing.

Resources:

• Eye injuries (NHS Choices) / Corneal superficial injury (CKS, 2022)