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Corneal Abrasion Tx
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Note: controversies are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also regarding your thought processes and the evidence behind your decisions. We can learn from each other!
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Kelly December 12, 2020 - 9:29 pm
24 hours of tetracaine drops has been shown to be safe and effective for simple corneal abrasions (discussion here strongly in favor of emergency physicians providing topical anesthetic for home use https://www.acepnow.com/article/science-has-repeatedly-debunked-this-stubborn-ophthamology-myth/?singlepage=1&theme=print-friendly). However, in this counterpoint by an ophthalmologist, it is important to be sure the diagnosis is simple corneal abrasion, and corneal abrasions usually heal rapidly on their own in 24-48 hours (https://www.nuemblog.com/blog/tetracaine). If you do choose to send the patient home with 24 hours worth of anesthetic drops, how much should you prescribe? The dose is 1-2 drops at a time, with a duration of action of 10-20 minutes. There are approximately 20 drops in a mL, so 2mL is a reasonable amount to prescribe.