Which of the following is considered an evidence-based component of routine management for an uncomplicated corneal abrasion in an adult patient without contact-lens use or high-risk contamination?
Send the patient home with topical anesthetic drops for use as needed for pain control.
Routinely instill cycloplegic drops in all corneal abrasions to prevent photophobia.
Apply an occlusive pressure patch for 24 hours to promote epithelial healing.
Prescribe a topical ophthalmic antibiotic ointment to reduce the risk of superinfection until the defect is healed.
Current literature supports prescribing a topical ophthalmic antibiotic (for example, erythromycin or bacitracin/polymyxin B ointment) to lower the risk of secondary bacterial keratitis while the corneal epithelium heals. Multiple randomized trials and meta-analyses show that pressure patches do not speed healing or reduce pain and may actually delay re-epithelialization; therefore, routine patching is discouraged. Home use of topical anesthetic drops is contraindicated because repeated dosing can impede healing and mask worsening symptoms. Routine cycloplegic or mydriatic drops are likewise not recommended for simple abrasions, as they provide no additional analgesic benefit in this setting. Most uncomplicated abrasions heal within 24-48 hours with lubrication, topical antibiotics, and oral analgesia as needed.
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Why is a topical ophthalmic antibiotic recommended for uncomplicated corneal abrasions?
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Why are pressure patches not recommended for corneal abrasions?
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Why is the use of topical anesthetic drops for home pain control contraindicated?
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Maxillofacial and Ocular Emergencies
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