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Corneal Abrasions: Advice For Parents

Corneal Abrasions:  Advice for Parents

McKenzie Pediatrics 2007

What Is A Corneal Abrasion?

Abrasions of the cornea result from traumatic removal of a portion of the epithelium, or surface, of the cornea. They are generally exquisitely painful, and are usually accompanied by extreme sensitivity to light, profuse tears, and spasms of the iris muscle.

How Do Doctors Find Corneal Abrasions?

If your child is suspected to have a corneal abrasion, a sterile fluoroscein ophthalmic litmus strip will be moistened with a topical anesthetic, and touched into the corner of your child’s eye. Harmless fluoroscein dye will coat the cornea’s surface. A special violet light will then be used in a darkened room to examine the eye. An abrasion will absorb the dye, and this will “light up” under the violet light.

How Are Corneal Abrasions Treated?

Most corneal abrasions, if treated properly, heal within 24-48 hours. An antibiotic eye solution or ointment will be applied here in the office, and then prescribed for home use every 4 hours while awake.

Depending on the degree of your child’s pain, he/she might also be prescribed a topical cycloplegic (for example, Cyclomydril™) to relax iris muscle spasms, or a topical anesthetic (for example, Proparacaine™). Either can be used every 6-8 hours as needed for pain or discomfort. Know that the cycloplegic, by relaxing the iris muscle, will also cause the pupil to dilate, and therefore may cause some temporary blurry vision and light sensitivity.

Aren’t We Supposed To Patch The Eye?

It used to be believed that an eye with a corneal abrasion was best patched to reduce the chance of rubbing or further damage. Recent large studies, however, have shown no difference in the time to healing between a patched and an unpatched eye. In fact, patching the eye of a young child may actually worsen the abrasion, as the child is more likely to continually rub or try to remove the patch.

How Do We Make Certain The Abrasion Heals?

We’d like to see your child back in 24-48 hours to recheck the eye, again with the fluoroscein dye. A decision will be made then as to how long to continue the medications. Usually, antibiotic drops are continue for 48 hours beyond the healing of the abrasion.

What Else Can I Do For My Child’s Pain?

Ibuprofen (Motrin™or Advil™) is preferable to Acetominophen (Tylenol™) for the relief of pain caused by corneal abrasions. In unusual cases of severe pain despite topical medications and oral ibuprofen, a low-strength narcotic will be prescribed for the short-term until healing.