BMJ  2004;328:643-644 (13 March), doi:10.1136/bmj.328.7440.643-b

Letter

ABC of eyes: Injury to the eye

Eye padding is not recommended for corneal abrasions

EDITOR—The evidence based literature does not concur with the recommendation by Khaw et al in the ABC of eyes that corneal abrasions be padded.^1-4 The topical use of non-steroidal anti-inflammatory drugs is preferred.⁵

Arc eye is incredibly painful, the pain often recurring at night after the patient has left the doctor's surgery. Is there evidence that the use of two 0.5 ml vials of local anaesthetic eye drops self administered at home, if necessary, is toxic to the cornea?

Little evidence recommends routine use of topical antibiotics for corneal abrasions, especially after removal of a foreign body. Would it not be better to prescribe hydroxypropyl methylcellulose/dextran-70 solution or topical non-steroidal anti-inflammatory drugs, using topical antibiotics only as needed, until the necessary trials answering this common problem are done?

77 Toronto Road, St Helena, Welkom, South Africa 9466 rkahn{at}icon.co.za

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Competing interests: None declared.

References

1. Khaw PT, Shah P, Elkington AR. ABC of eyes. Injury to the eye. BMJ 2004;328: 36-8. (3 January.)[Free Full Text]
2. Flynn CA, D'Amico F, Smith G. Should we patch corneal abrasions: a meta-analysis. J Fam Pract 1998;47: 264-70.[Medline]
3. Michael JG, Hug D, Dowd MD. Management of corneal abrasion in children: a randomised controlled trial. Ann Emerg Med 2002;40: 67-72.[CrossRef][Medline]
4. Arbour JD, Brunette I, Boisjoly HM, Shi ZH, Dumas J, et al. Comment: should we patch corneal erosions? Arch Ophthalmol 1997;115: 313-7.[Abstract]
5. Solomon A, Halpert M, Frucht-Pery J. The use of topical indomethacin and eye patching for minor corneal trauma. Ann Ophthalmol 2000;32: 316-9.[CrossRef]

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Relevant Article

Injury to the eye

P T Khaw, P Shah, and A R Elkington
BMJ 2004 328: 36-38. [Extract] [Full Text] [PDF]