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A 4-year-old boy is brought in for right eye pain. His little brother accidentally threw a small toy that hit him in the face. Since then, the patient is crying and keeping his eye closed. On exam, there is no laceration. His pupil is round and reactive. There is no hyphema and no eye discharge. Flipping the eyelid reveal no evidence of foreign body. Fluorescein exam reveals uptake covering a small spot comprising 20% of the cornea.
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August 9, 2024 at 5:53 pm
B) Treatment should include topical antibiotics such as erythromycin ointment
Corneal abrasion is one of the most common eye injuries. Common mechanisms of injury are minor trauma, a foreign body, or an accidental scratch with a fingernail. They present with pain, difficulty opening the eye, photophobia, and foreign body sensation. It is important to rule out globe rupture, hyphema, hypopyon, and decreased visual acuity. In young children, visual acuity can be assessed using charts with shapes, pictures, or tumbling E’s. Check whether the patient wears contact lenses. Uncomplicated corneal abrasions are treated with topical antibiotics, typically an ointment since it provides lubrication as well, and analgesia. Patching is no longer recommended, and topical corticosteroids should never be prescribed by a non-ophthalmologist. Follow-up prn or with primary care is sufficient.