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corneal abrasion
Etiology:
- traumatic
- mechanical
- foreign body
- contact lens
Pathology:
- superficial corneal epithelium defects [1]
Clinical manifestations:
- eye pain
- foreign body sensation
- light sensitivity
- tearing
- photophobia
- visual impairment
- injected conjunctiva
- red reflex is normal
- cornea has irregular light reflex
- symtoms generally occur immediately after blunt trauma
Special laboratory:
- cornea stain with fluorescein [3]
Differential diagnosis:
- post-traumatic iritis
- may develop 2-3 days after injury
- miosis
- no foreign body sensation
Management:
1) if organic matter cause of corneal abrasion
- fluoroquinolone ophthalmic
- finger cause should cover Pseudomonas
2) inorganic matter cause of corneal abrasion
- erythromycin ophthalmic
- bacitracin ointment
3) Maxitrol (topical glucocorticoids should never be used) [3]
4) referral to an ophthalmologist for persistent symptoms
- slit-lamp examination
5) eye patch for traumatic abrasions is NOT useful & it impairs vision
a) impaired binocular vision
b) reduced visual field
6) topical anesthetic not indicated
Related
bacitracin (AK-tracin)
cornea (C, K)
dexamethasone/neomycin/polymixin-B (Maxitrol, Dexasporin)
erythromycin (Eryc, Eryctte, E-mycin, Ilotycin, AK-Mycin, A/T/S, T-stat)
General
corneal disease (keratopathy)
trauma
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, 17, 18.
American College of Physicians, Philadelphia 1998, 2015, 2018.
- Medical Knowledge Self Assessment Program (MKSAP) 19
Board Basics. An Enhancement to MKSAP19.
American College of Physicians, Philadelphia 2022
- Journal Watch 21(18):144, 2001
- Le Sage N, Verreault R, Rochette L.
Efficacy of eye patching for traumatic corneal abrasions:
a controlled clinical trial.
Ann Emerg Med 38:129, 2001
PMID: 11468606
- NEJM Knowledge+ Ophthalmology
- Wipperman JL, Dorsch JN.
Evaluation and management of corneal abrasions.
Am Fam Physician. 2013 Jan 15;87(2):114-20.
PMID: 23317075 Free article.