Corneal abrasion treatment
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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:
- Compared an eye patch with no eye patch for at least 24 hours.
- Primary outcome was time to resolution of the abrasion and pain.
- Patients at least 6 years of age.
- Abrasion due to traumatic injury or removal of a foreign body (but not contact
lenses).
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.
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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:
- CA Flynn, F D'Amico, G Smith. Journal of Family Practice 1998 47:
264-270.
- PL Gregersen et al. Behandlingen af abrasio corneae. Ugeskr Laegr 1991 30:
2123-4.
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