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two trials finding better pain control with no patching. Furthermore, the
data (including pediatric studies) suggest that patching may in fact delay
healing. 4,10,17–23
There has been limited study of cycloplegic use in CA. An RCT showed no
benefit as assessed by either pain score improvement or need for rescue oral
analgesics. 8
n Summary and recommendations
First line: topical NSAID (e.g. ketorolac 0.5%, 1 drop QID)
Reasonable: oral opioids (e.g. 5–10 mg oxycodone PO q4–6h)
Pregnancy: acetaminophen (1000 mg PO q4–6 h) with as-needed opioids
(e.g. hydrocodone 5–10 mg PO q4–6h)
Pediatric: topical NSAID (e.g. ketorolac 0.5%, 1 drop QID) or systemic NSAID
(e.g. ibuprofen 10 mg/kg PO q4–6h)
References
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1. Calder LA, Balasubramanian S, Fergusson D. Topical nonsteroidal antiinflammatory
drugs for corneal abrasions: meta-analysis of randomized
trials. Acad Emerg Med. 2005;12(5):467–473.
2. Donnenfeld ED, Selkin BA, Perry HD, et al. Controlled evaluation of a bandage
contact lens and a topical nonsteroidal anti-inflammatory drug in treating
traumatic corneal abrasions. Ophthalmology. 1995;102(6):979–984.
3. Goyal R, Shankar J, Fone DL, et al. Randomised controlled trial of ketorolac in
the management of corneal abrasions. Acta Ophthalmol Scand. 2001;79
(2):177–179.
4. Kaiser PK. A comparison of pressure patching versus no patching for corneal
abrasions due to trauma or foreign body removal. Corneal Abrasion Patching
Study Group. Ophthalmology. 1995;102(12):1936–1942.
5. Alberti MM, Bouat CG, Allaire CM, et al. Combined indomethacin/gentamicin
eyedrops to reduce pain after traumatic corneal abrasion. Eur J Ophthalmol.
2001;11(3):233–239.