Practice patterns in the interdisciplinary management of corneal abrasions

Abstract

ObjectiveTo characterize the treatment and follow-up patterns of corneal abrasions at an academic health centre. MethodsThis is a retrospective review of 90 cases of corneal abrasions over a 2-year period at a tertiary care academic hospital, of which 75 were seen by the ophthalmology department. All consultations primarily for corneal abrasion, as determined by the emergency department physician, were included in the study. Information on treatment regimen, corneal findings by emergency and ophthalmology physicians, time between follow-ups, and final outcomes was collected. ResultsSeventy-five patients were seen by ophthalmology a median of 1 day after the emergency room visit. Twenty-five of these patients did not arrive for their subsequent follow-up appointment. Twenty-two of the abrasions were healed by the time of the ophthalmology examination, 51 patients had unhealed corneal abrasions, and 2 had corneal ulcers. Management was changed in 29 of the patients by ophthalmology. The most common management changes were hypertonic saline ointment for prophylaxis or treatment of recurrent erosion syndrome, followed by bandage contact lenses for comfort. ConclusionsCorneal abrasions are a common condition, and practice patterns for follow-up vary widely. Although the vast majority of patients do very well and likely would heal on their own without ophthalmology referral, it seems reasonable that patients with corneal abrasions are assessed once by an ophthalmologist immediately or possibly up to 1–2 days after the initial emergency visit, depending on the individual patient circumstances.