corneal abrasion
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Etiology
- traumatic
- mechanical
- foreign body
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
Diagnostic procedures
- cornea stain with fluorescein[3]
Differential diagnosis
- post-traumatic iritis
- may develop 2-3 days after injury
- miosis
- no foreign body sensation
Management
- if organic matter cause of corneal abrasion
- fluoroquinolone ophthalmic
- finger cause should cover Pseudomonas
- fluoroquinolone ophthalmic
- inorganic matter cause of corneal abrasion
- erythromycin ophthalmic
- bacitracin ointment
- Maxitrol (topical glucocorticoids should never be used)[3]
- referral to an ophthalmologist for persistent symptoms
- eye patch for traumatic abrasions is NOT useful & it impairs vision
- topical anesthetic not indicated
More general terms
Additional terms
- 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)
References
- ↑ 1.0 1.1 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: https://www.ncbi.nlm.nih.gov/pubmed/11468606 - ↑ 3.0 3.1 3.2 NEJM Knowledge+ Ophthalmology
Wipperman JL, Dorsch JN. Evaluation and management of corneal abrasions. Am Fam Physician. 2013 Jan 15;87(2):114-20. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23317075 Free article.