Treatment Of Corneal Abrasions Research Articles

3D Electrohydrodynamic Printing of Contact Lens‐Like Chloramphenicol‐Loaded Patches for Corneal Abrasions Treatment

Corneal abrasion is a common traumatic emergency, which can cause eyelid photophobia, tearing, and obvious foreign body sensation and pain. Herein, the 3D contact lens‐like chloramphenicol‐loaded patches composed of well‐organized micrometer fibers are prepared via electrohydrodynamic (EHD) printing to treat corneal abrasions. The main material of these patches is cellulose acetate (CA), and chloramphenicol (CAM) is loaded in the patches. EHD printing can realize micrometer fibers stacked layer by layer to form a customizable shape suitable for eye wear. Herein, the surface morphology, chemical as well as physical properties, transparency, drug release behaviors, and biocompatibility of the patches loading various concentrations of CAM are studied. It is found that the CAM‐loaded patches have 3D hemispherical shape similar to contact lens and smooth surface morphology. Moreover, patches loaded with different concentrations of CAM all maintain good water absorption, hydrophilicity, light transmittance, and biocompatibility. The drug release curves of CAM‐loaded patches show that the contact lens‐like patches have high loading efficiency and can achieve sustained release of CAM, indicating clinical potential in the treatment of corneal abrasions.

Antibiotic prophylaxis for corneal abrasion.

Corneal abrasion is a common disorder frequently faced by ophthalmologists, emergency physicians, and primary care physicians. Ocular antibiotics are one of the management options for corneal abrasion. A comprehensive summary and synthesis of the evidence on antibiotic prophylaxis in traumatic corneal abrasion is thus far unavailable, therefore we conducted this review to evaluate the current evidence regarding this important issue. To assess the safety and efficacy of topical antibioticprophylaxis following corneal abrasion. Our objectives were 1) to investigate the incidence of infection with antibiotics versus placebo or alternative antibiotics in people with corneal abrasion; and 2) to investigate time to clinical cure, defined as complete healing (re-epithelialization) of the epithelium, with antibiotics versus placebo or alternative antibiotics in people with corneal abrasion. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register; 2021, Issue 4), Ovid MEDLINE, Embase.com, PubMed, the Latin American and Caribbean Health Sciences Literature database (LILACS), ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 25 April 2021. We included randomized controlled trials (RCTs) comparing antibiotic with another antibiotic or placebo in children and adults with corneal abrasion due to any cause. We used standard Cochrane methodology and assessed the certainty of the body of evidence for the prespecified outcomes using the GRADE classification. Our search of the electronic databases yielded 8661 records. We screened 7690 titles and abstracts after removal of duplicates. We retrieved 32 full-text reports for further review. We included two studies that randomized a total of 527 eyes of 527 participants in the review. One study was conducted in Denmark, and one was conducted in India. The two studies did not examine most of our prespecified primary and secondary outcomes. The first study wasaparallel-group RCT comparing chloramphenicol ocular ointment with fusidic acidocular gels (frequency was not clearly reported). This studyenrolled 153 participants older than 5 yearsof age with corneal abrasion in Denmark with a one-day follow-up duration.No participants had secondary infection in the fusidic acid group, whereas three (4.1%) participants in the chloramphenicol group had a slight reaction (risk ratio [RR] 0.15, 95% confidence interval [CI] 0.01 to 2.79; 144 participants; very low certainty evidence). Thirty-one(44.3%) participants in the fusidic acid arm and 34 (46.6%) participants in the chloramphenicol arm were cured(defined as the area of abrasion zero and no infection) at day 1(RR0.94, 95% CI0.65 to 1.34; 144 participants; very low certainty evidence).Without providing specific data, the study reported that the degree of pain was not affected by the interventions received. The most common adverse events reported were itching and discomfort of the eye, which occurred in approximately one-third of participants in each group (low certainty evidence). A secondmulticenter, two-arm RCT conducted in India enrolled 374 participants older than 5 years of age with corneal abrasion who presented within 48 hours after injury. This studyinvestigated the effect of a three-day course of either ocular ointment combinations of chloramphenicol-clotrimazole or chloramphenicol-placebo(all three times daily). At day 3,169 (100%) participants in thechloramphenicol-clotrimazole armand203 (99%) out of 205 participants in the chloramphenicol-placebo armwere cured without any complication, defined ascomplete epithelialization of the cornea without evidence of infection (RR1.01, 95% CI0.99 to 1.03; 374 participants; very low certainty evidence). Fourparticipants assigned tothe chloramphenicol-placebo armexperienced mild adverse events: two participants (1%) had mild chemosis and irritation, and two (1%) had small single sterile corneal infiltrates (low certainty evidence). Given the low to very low certainty of the available evidence, any beneficial effects of antibiotic prophylaxis in preventing ocular infection or accelerating epithelial healing following a corneal abrasion remain unclear. Moreover, the current evidence is insufficient to support any antibiotic regimen being superior to another. There is a need for a well-designed RCT assessing the efficacy and safety of ocular antibiotics in the treatment of corneal abrasion with a particular focus on high-risk populations and formulation of interventions.

Effectiveness of patching and non-patching in treatment of corneal abrasion: A comparative study

The aim was to compare the effectiveness between patching and non-patching in the treatment of non-infected, non-contact lens related traumatic corneal abrasions, as well as of abrasions following foreign body removal. A prospective, controlled, randomized study on 100 patients over 1 year who presented with ocular pain, with a history of trauma or foreign body removal & had corneal abrasion on fluorescein stain. Patients were randomized into two groups: with patch group (receiving an eye patch with topical antibiotics) and no patch group (topical antibiotics with no eye patch) and patients were followed up. Patients with corneal abrasions healed significantly faster and relieved symptomatically in the no patch group. We conclude that routine use of eye patching is not effective in the healing of simple corneal abrasion.

Travmatik korneal abrazyon hastalarında Dekspantenol kullanımının hasta konforuna olan etkisi

Objective: The aim in this study was to investigate if the use of Dexpanthenol could play a role in the relief of pain in the treatment of corneal abrasions (CA). Methods: Patients presenting to the BLINDED with a diagnosis of CA were conducted in this retrospective, case-control study. A detailed ocular examination was done and pain severity was assessed using a visual analogue scale (VAS) score. In group 1, subjects were treated with only topical ofloxacin %0.3 while subjects in group 2 were treated with topical ofloxacin %0.3 and dexpanthenol. Foreign body sensation, photophobia, excessive lacrimation and VAS were documented at follow up examinations. Results: 70 patients were allocated into group 1 and 68 patients were allocated into group 2. At each visit, there were significant differences in VAS scores between the groups (p<0.005). VAS scores were lower in group-2. There were no statistically significant differences between two groups in terms of photophobia, foreign body sensation, excessive lacrimation (p>0.05). All patients were free of any complications. Conclusion: Although it was shown that adding topical dexpanthenol to the treatment regimen could permit faster pain relief in treating CAs, the prospective studies should be done. Key words: Traumatic corneal abrasion, Dexpanthenol, Visual analogue scale.

What is the best treatment of corneal abrasion?

What is the best treatment of corneal abrasion?

Safety and Effectiveness of Topical Anesthetics in Corneal Abrasions: Systematic Review and Meta-Analysis

BackgroundTopical anesthetics are used in the emergency department (ED) to relieve eye pain and allow eye examinations in patients with corneal abrasions. There is concern for delayed corneal healing, which is associated with the long-term use of topical anesthetics, so outpatient use is not recommended. ObjectivesWe sought to systematically study the effectiveness and complications associated with the short-term use of topical anesthetics (≤72 hours) in the management of patients presenting to EDs with corneal abrasions. MethodsFour electronic databases were searched from inception of the database until April 2014. We included studies of patients >16 years of age who were using topical anesthetics for <72 hours. Postoperative cases were not included. ResultsA total of 140 patients (68 in the intervention group and 72 in the control group) from 2 randomized trials were included in the analysis. Comparing control patients who did not use topical anesthetics to study patients who did use topical anesthetics, this meta-analysis found no significant difference in pain scores (standardized mean difference −1.01 [95% confidence interval {CI} −2.39 to 0.38), corneal healing (OR 1.31 [95% CI 0.53–3.27), or persistent symptoms (OR 0.98 [95% CI 0.06–16.69). The 2 trials reported no adverse effects. ConclusionThere were no differences regarding pain, persistent symptoms, or corneal healing when comparing short-term use of topical anesthetics to placebo in the treatment of corneal abrasion. Data on safety are sparse, and the use of this treatment is currently not supported by evidence.

The Safety of Topical Anesthetics in the Treatment of Corneal Abrasions: A Review

BackgroundDespite the fact that topical anesthetics provide superb analgesia to the painful eye, they are not prescribed routinely to patients when they are discharged from the emergency department because of concerns for delayed healing and corneal erosion. ObjectiveTo summarize the evidence for the safety of topical proparacaine and tetracaine for pain relief in patients with corneal abrasions. MethodsThis is a systematic review looking at the use of topical anesthetic agents in the treatment of corneal abrasions in the emergency department. ResultsOur literature search produced two emergency department−based, randomized, double blind, placebo-controlled studies on human patients with corneal abrasions. Additionally, we found four studies that investigated the application of topical anesthetics in patients who underwent photorefractive keratectomy. All six studies demonstrated that a short course of dilute topical anesthetic provided efficacious analgesia without adverse effects or delayed epithelial healing. ConclusionLimited available data suggests that the use of dilute topical ophthalmologic proparacaine or tetracaine for a short duration of time is effective, though their safety for outpatient use is inconclusive.

The Use of Topical Honey in the Treatment of Corneal Abrasions and Endotoxin-Induced Keratitis in an Animal Model

Purpose: To investigate the effect of topically applied honey on intact corneas, surgically induced corneal abrasions and endotoxin induced keratitis.Materials and Methods: The effect of honey on the cornea was investigated by application of honey on intact corneas, wounded corneas and endotoxin-induced keratitis in Lewis rats. The corneas were wounded by creating an epithelial defect using a surgical blade, and the keratitis was induced by topically applying Pseudomonas aeruginosa endotoxin to scarified corneas. After treatment rats were sacrificed and cornea harvested in each case. Corneas were processed for paraffin embedding for histological and immuno-fluorescence staining. Corneas were also harvested and processed for total ribonucleic acid (RNA) isolation for reverse transcriptase-polymerase chain reaction (RT-PCR) analysis for various growth factors and inflammatory chemokines/cytokines).Results: Histological analysis revealed that no inflammation or morphological changes occurred after honey treatment in naive intact corneas. Vascular endothelial growth factor (VEGF) levels were also not altered after honey treatment. Topical application of honey to injured corneas resulted in faster epithelial healing and decreased expression of VEGF, transforming growth factor beta (TGF-β), interferon gamma (IFN-γ), interleukin 12 (IL-12) and tumor necrosis factor alpha (TNF-α) in injured corneas. Our results also established that honey treatment reduced the inflammation in endotoxin-induced keratitis by reducing the levels of angiogenic factors (VEGF and TGF-β), inflammatory cytokines (IL-12) and chemokines (CC chemokine receptor 5(CCR-5)).Conclusion: Short term use of honey on intact corneas can be safe. Honey has anti-angiogenic and anti-inflammatory properties that can be explored in several corneal inflammatory and infectious conditions.

Treatment of Corneal Abrasion in Children with Topical Nonsteroidal Anti-Inflammatory Drops without Pressure Patching

A non-comparative interventional case series to evaluate the effectiveness of non-steroidal anti-inflammatory (NSAID) drops in the management of non-infected, traumatic corneal abrasion with no pressure patch in children. One hundred patients with non-infected traumatic corneal abrasion less than 10 mm 2 in size and less than 12 hours in duration were studied. All patients received a cycloplegic eye drops at the time of presentation and were instructed to instill Diclofanic sodium 1.0 mg. Eye drops (Voltaren, Ciba Vision Ltd.) four times daily and Fucidic acid 10 mg (Fucithalmic Eye Ointment, LEO Pharmaceutical). The children that presented with closed eyes had more lid edema, photophobia, lacrimation and pain score than patient presented with open eyes (p < 0.001). This dissimilarity disappeared in the second day with no statistical differences. Five children (5%) preferred to close their eye on the first day for the pain. By the second day, all the patients had a lower pain score with no discomfort. Traumatic corneal abrasion can be managed safely in children with no pressure patch and with topical NSAID to relieve the pain and the discomfort that follow the incidence with no side effect.

Safety and efficacy of diclofenac ophthalmic solution in the treatment of corneal abrasions

Study objective: To determine whether the use of diclofenac ophthalmic solution is a safe and effective analgesic in the treatment of traumatic corneal abrasions in the emergency department. Methods: We conducted a prospective, randomized, double-blinded, placebo-controlled clinical trial. Consenting consecutive patients with corneal abrasions who presented to a community-based ED from August through February 1998 were randomly assigned to receive either diclofenac or control vehicle drops. Pain relief was measured using a visual Numeric Pain Intensity Scale (NPIS) before and after treatment. Exclusion criteria were as follows: age younger than 18 years, pregnancy, history of glaucoma, ocular infection, recent eye surgery, other signs of ocular trauma, narcotics within 6 hours, minimal pain (NPIS score <3), and any allergy to diclofenac or nonsteroidal anti-inflammatory drugs. Patients were discharged with study drug or control vehicle solution, a topical antibiotic, oxycodone-acetaminophen as a rescue analgesic, and a pain diary. The outcome measurements were improvement in NPIS score 2 hours after treatment, use of oxycodone-acetaminophen, and occurrence of any adverse effects. Results: Forty-nine patients were enrolled in the study; 25 received diclofenac and 24 received control vehicle drops. Both groups were similar in gender, age, pretreatment pain duration, NPIS score, and analgesic use. There was significantly greater improvement in the 2-hour NPIS score in the diclofenac group (3.1; 95% confidence interval [CI] 2.3 to 4) compared with the control group (1.0; 95% CI 0.1 to 2.0). The difference between the 2 groups was 2.1±1.3 (95% CI 0.8 to 3.4). There was a trend toward fewer patients taking rescue oxycodone-acetaminophen in the diclofenac group (20%; 95% CI 4% to 36%) versus the control group (42%; 95% CI 22% to 62%). Other than transient mild stinging, there were no complications associated with diclofenac use. Conclusion: Diclofenac ophthalmic solution appears to be a safe and effective analgesic in the treatment of traumatic corneal abrasions in the ED. [Szucs PA, Nashed AH, Allegra JR, Eskin B. Safety and efficacy of diclofenac ophthalmic solution in the treatment of corneal abrasions. Ann Emerg Med. February 2000;35:131-137.]

A Study of Topical Nonsteroidal Anti-inflammatory Drops and No Pressure Patching in the Treatment of Corneal Abrasions

To evaluate the effectiveness of an ophthalmic nonsteroidal anti-inflammatory drug (NSAID) in the treatment of noninfected, non-contact lens-related, traumatic corneal abrasions and no pressure patch. A single-center, randomized, double-masked, placebo-controlled study. One hundred patients with noninfected, non-contact lens-related, traumatic or foreign body removal-related corneal abrasions less than 36 hours in duration. All patients received a cycloplegic drop and erythromycin or polymyxin B (Polysporin Ophthalmic Ointment, Burroughs Wellcome, Research Triangle Park, NC). Patients were then randomized to receive either ketorolac tromethamine 0.5% ophthalmic solution or control vehicle drops. The main outcome measures were six subjective symptoms monitored daily, evaluation of corneal abrasion, and determination of adverse events. Long-term complications were determined 3 to 8 months after randomization. Twelve patients were excluded from the study. One day after randomization, patients receiving ketorolac tromethamine 0.5% ophthalmic solution noted significantly decreased levels of pain (P < 0.002), photophobia (P < 0.009), and foreign body sensation (P < 0.003) as compared with the control vehicle group. In addition, the time to resumption of normal activities was shorter in the group who received ketorolac tromethamine 0.5% ophthalmic solution (P < 0.001). There was no statistical difference in the amount of tearing, healing time, acuity changes, or complication rates between the two groups. Ketorolac tromethamine 0.5% ophthalmic solution provides increased patient comfort without clinical adverse effects when used as adjunctive therapy in the treatment of noninfected, non-contact lens-related, traumatic corneal abrasions.

Treatment of Corneal Abrasions

To the Editor. —We were pleased to see a recent Questions and Answers 1 address the issue of whether there is any evidence for a beneficial effect of patching the eye after a superficial corneal abrasion. In contrast to the answer provided, there is little support in the medical literature for routine use of an eye patch. In the discussion, the consultant addresses healing rates and pain, two patient-oriented outcomes of importance. While the consultant correctly stated that there is definite evidence that patching an eye with a corneal abrasion results in faster healing, he relied on anecdote rather than the clinical literature when concluding that use of an eye patch reduces pain. At least two randomized controlled trials have been published that refute the common clinical impression that eye patches reduce pain. Hulbert studied eye patch use in 30 patients, finding that an eye patch conferred no benefit

Treatment of corneal abrasions

Treatment of corneal abrasions

Treatment of Corneal Abrasions-Reply

In Reply. —In response to Drs Mindlin and Slawson regarding treatment of corneal abrasions, cycloplegia and semipressure patching for treatment of non—contact lens—related corneal abrasions has been the standard of care at Wilmer Eye Institute and is recommended by textbooks of ocular emergencies. 1 In our opinion, the possibility of confusing one cycloplegic agent with another is not reason enough not to use them as an effective medication. Two recent articles do suggest that the symptoms and signs of corneal abrasions can be effectively treated without patching. 2,3

Treatment of Corneal Abrasions

Treatment of Corneal Abrasions

Treatment of corneal abrasions

To the Editor. —We were pleased to see a recent Questions and Answers 1 address the issue of whether there is any evidence for a beneficial effect of patching the eye after a superficial corneal abrasion. In contrast to the answer provided, there is little support in the medical literature for routine use of an eye patch. In the discussion, the consultant addresses healing rates and pain, two patient-oriented outcomes of importance. While the consultant correctly stated that there is "no definite evidence that patching an eye with a corneal abrasion results in faster healing," he relied on anecdote rather than the clinical literature when concluding that use of an eye patch reduces pain. At least two randomized controlled trials have been published that refute the common clinical impression that eye patches reduce pain. Hulbert studied eye patch use in 30 patients, finding that an eye patch conferred no benefit

Eye Patch Treatment for the Pain of Corneal Abrasion

The traditional use of patching and topical antibiotics in the treatment of corneal abrasion has recently been challenged, particularly after foreign body removal. In a prospective, controlled, randomized study of 33 patients treated in the emergency department for eye pain and corneal abrasion, we attempted to determine whether eye patching affected the pain of simple corneal abrasions. After fluorescein examination with magnification (x 5), a visual analog pain score was recorded and the patient was randomized to either the patched or nonpatched group. A standard analgesic was supplied, and all patients had follow-up at 24 hours, when repeat pain scores and analgesic use were recorded. The groups were compared by using the Wilcoxon's rank sum test, Student's t test, and analysis of covariance as required. There was no significant difference in the mean changes in pain scores between the patched and nonpatched groups. Analgesic use was also similar. We conclude that routine eye patching does not favorably affect the pain associated with the treatment of simple corneal abrasion.

Treatment of Corneal Abrasions With Soft Contact Lenses and Topical Diclofenac

Treatment of corneal abrasions often involves antibiotic ointment and pressure patching. The corneal abrasions following excimer laser photorefractive keratectomy have been managed with disposable soft contact lenses and diclofenac (Voltaren) eye drops. We report 13 patients with corneal abrasions from trauma or recurrent corneal erosions treated with application of a disposable soft contact lens and instillation of diclofenac and antibiotic eye drops. All 13 patients reported significant pain relief and all abrasions healed within 3 days (most within 24 hours). Two of the recurrent erosion patients suffered subsequent spontaneous abrasions and one of the traumatic abrasion patients developed a possible infectious keratitis which cleared without visual loss. In this small series, the combination of a disposable soft contact lens and the instillation of diclofenac drops provided significant pain relief while the abrasion healed and allowed the patients to function with binocular vision. This treatment regimen offers an alternative to pressure patching in the treatment of corneal abrasions.

Eye patch treatment for the pain of corneal abrasion

The traditional use of patching and topical antibiotics in the treatment of corneal abrasion has recently been challenged, particularly after foreign body removal. In a prospective, controlled, randomized study of 33 patients treated in the emergency department for eye pain and corneal abrasion, we attempted to determine whether eye patching affected the pain of simple corneal abrasions. After fluorescein examination with magnification (x 5), a visual analog pain score was recorded and the patient was randomized to either the patched or nonpatched group. A standard analgesic was supplied, and all patients had follow-up at 24 hours, when repeat pain scores and analgesic use were recorded. The groups were compared by using the Wilcoxon's rank sum test, Student's t test, and analysis of covariance as required. There was no significant difference in the mean changes in pain scores between the patched and nonpatched groups. Analgesic use was also similar. We conclude that routine eye patching does not favorably affect the pain associated with the treatment of simple corneal abrasion.

The Effect of Tobramycin Soaked Collagen Shields in the treatment of Corneal Abrasions

The Effect of Tobramycin Soaked Collagen Shields in the treatment of Corneal Abrasions