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Corneal abrasion treatment


If someone suffers a corneal abrasion through an accident, does padding the eye with an eye patch help it heal? The answer from a systematic review [1] is that eye patches are a waste of time.

Review


A very thorough searching process (including contacting authors for data) sought randomised trials (mainly in English) which had the following criteria:

Results


Seven trials (with 608 patients) were found, three of which used fluorescein to assess healing and four used a slit lamp. Eye patches were of several types, but in essence all used cotton wool, gauze, pads or bandages taped over the eye to keep it closed. Most studies were in emergency departments or eye hospitals. Follow up was generally thorough. Outcomes were generally assessed by observers aware of treatment.

Five trials had data for analysis. Healing rates at days 1 and 2 are shown in the Figure.



There was no statistical difference either at day 1 (relative risk 0.87; 0.68 to 1.13) or at day 2 (1.01; 0.65 to 1.55). For pain, two of the six studies which measured it found less pain in the unpatched group. Complications were few (four in the padded group, two in the non padded patients).

Comment


A simple question, this, and it is interesting to see that at least eight trials have looked at it (a pity that one Danish paper was not included omment. The Danish study that was excluded from because it did not meet the inclusion criteria of patch vs no patch, but compared 1 patch vs. double eye patch. Given how fiddly eye patches are, the knowledge that they are no use and can be dispensed with is worthwhile. Bandolier 's Scandinavian correspondent supplied the Danish reference [2] which was not included, and which compared chloramphenicol ointment plus patch for six hours followed by chloramphenicol drops for six days with choramphenicol ointment plus double eye patches for 24 hours. The conclusion was that double eye patches were better, but the groups were small, and exclusions were high. This trial would not have altered the overall conclusions.

Reference:

  1. CA Flynn, F D'Amico, G Smith. Journal of Family Practice 1998 47: 264-270.
  2. PL Gregersen et al. Behandlingen af abrasio corneae. Ugeskr Laegr 1991 30: 2123-4.



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