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Corneal Abrasion

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1. Are Topical Nonsteroidal Anti-Inflammatory Drugs Useful for Analgesia in Patients With Traumatic Corneal Abrasions?

Are Topical Nonsteroidal Anti-Inflammatory Drugs Useful for Analgesia in Patients With Traumatic Corneal Abrasions? Are Topical Nonsteroidal Anti-Inflammatory Drugs Useful for Analgesia in Patients With Traumatic Corneal Abrasions? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 73, Issue 2, Pages 157–159 Are Topical Nonsteroidal Anti-Inflammatory Drugs Useful for Analgesia in Patients (...) With Traumatic Corneal Abrasions? x Jason R. West , MD (EBEM Commentator) Department of Emergency Medicine, Lincoln Medical and Mental Health Center, Bronx, NY DOI: | Publication History Published online: December 04, 2018 Expand all Collapse all Article Outline Take-Home Message There is no strong evidence to suggest that topical nonsteroidal anti-inflammatory drugs provide adequate analgesia for patients with traumatic corneal abrasions, yet there is low-quality evidence to suggest that the drugs decreased

2019 Annals of Emergency Medicine Systematic Review Snapshots

4. Corneal abrasions

Corneal abrasions Corneal abrasions - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Corneal abrasions Last reviewed: February 2019 Last updated: March 2018 Summary Onset is usually sudden, and typical symptoms include a foreign body sensation (even if none present), photophobia, excessive tearing, blepharospasm, and blurry vision. Treatment involves adequate analgesia and topical antibiotics. Contact lens wearers (...) are at increased risk of Pseudomonas infection. Most abrasions heal within 1 or 2 days and have very few sequelae. Larger defects, or those associated with contact lens use, should have ophthalmological follow-up in 1 to 2 days to ensure healing. Complications are rare but include corneal ulceration and keratitis. Definition Corneal abrasions are corneal epithelial defects. They are common and are typically caused by mechanical trauma from external objects such as fingernails and branches, foreign bodies

2018 BMJ Best Practice

5. Topical non-steroidal anti-inflammatory drugs for analgesia in traumatic corneal abrasions. (PubMed)

Topical non-steroidal anti-inflammatory drugs for analgesia in traumatic corneal abrasions. Traumatic corneal abrasions are relatively common and there is a lack of consensus about analgesia in their management. It is therefore important to document the clinical efficacy and safety profile of topical ophthalmic non-steroidal anti-inflammatory drugs (NSAIDs) in the management of traumatic corneal abrasions.To identify and evaluate all randomised controlled trials (RCTs) comparing the use (...) of topical NSAIDs with placebo or any alternative analgesic interventions in adults with traumatic corneal abrasions (including corneal abrasions arising from foreign body removal), to reduce pain, and its effects on healing time.We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 2), MEDLINE Ovid (1946 to 30 March 2017), Embase Ovid (1947 to 30 March 2017), LILACS (Latin American and Caribbean Health Sciences

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2017 Cochrane

6. Corneal abrasion

Corneal abrasion Corneal abrasion submit The College submit You're here: Corneal abrasion Corneal abrasion The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Aetiology Loss of corneal epithelial tissue due to: sub-tarsal foreign body trauma (e.g. fingernail, twig, edge of paper, mascara brush) contact lens related trauma trichiasis (e.g. lash (...) depth edge quality oedema beneath abrasion confirm no corneal foreign body present If corneal foreign body present, (see Clinical Management Guideline on ) Evaluate anterior chamber reaction Evert eyelids to confirm no foreign body present If sub-tarsal foreign body present, (see Clinical Management Guideline on ) Advise patient to return/seek further help if symptoms persist (potential for development of Recurrent Epithelial Erosion Syndrome (see CMG on ) Advise on suitable eye protection (GRADE

2018 College of Optometrists

7. Patching for corneal abrasion. (PubMed)

Patching for corneal abrasion. Published audits have demonstrated that corneal abrasions are a common presenting eye complaint. Eye patches are often recommended for treating corneal abrasions despite the lack of evidence for their use. This systematic review was conducted to determine the effects of the eye patch when used to treat corneal abrasions.The objective of this review was to assess the effects of patching for corneal abrasion on healing and pain relief.We searched CENTRAL (which (...) which randomised a total of 1080 participants in the review. Four trials were conducted in the United Kingdom, another four in the United States of America, two in Canada, one in Brazil and one in Switzerland. Seven trials were at high risk of bias in one or more domains and one trial was judged to be low risk of bias in all domains. The rest were a combination of low risk or unclear.People receiving a patch may be less likely to have a healed corneal abrasion after 24 hours compared to those

2016 Cochrane

8. Acute hyperalgesia and delayed dry eye after corneal abrasion injury (PubMed)

Acute hyperalgesia and delayed dry eye after corneal abrasion injury Corneal nerves mediate pain from the ocular surface, lacrimation, and blinking, all of which protect corneal surface homeostasis and help preserve vision. Because pain, lacrimation and blinking are rarely assessed at the same time, it is not known whether these responses and their underlying mechanisms have similar temporal dynamics after acute corneal injury.We examined changes in corneal nerve density, evoked and spontaneous (...) pain, and ocular homeostasis in Sprague-Dawley male rats after a superficial epithelial injury with heptanol. We also measured changes in calcitonin gene-related peptide (CGRP), which has been implicated in both pain and epithelial repair.Hyperalgesia was seen 24 hours after abrasion injury, while basal tear production was normal. One week after abrasion injury, pain responses had returned to baseline levels and dry eye symptoms emerged. There was no correlation between epithelial nerve density

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2018 Pain Reports

10. Briefs: Corneal Abrasions (Re-post)

Briefs: Corneal Abrasions (Re-post) Briefs: Corneal Abrasions (Re-post) – PEMBlog Search for: Search for: Briefs: Corneal Abrasions (Re-post) This post will just scratch the surface in its exploration of the diagnosis and management of corneal abrasions. What is the best technique for getting the fluorescin into the eye? First of all, please don’t jab the patient’s eye with the fluorescin strip itself. You can actually cause a corneal abrasion that way. In the past I would drip the tetracaine (...) 11th, 2017 4 Comments Hala December 15, 2017 at 2:00 AM When to referred pt with corneal abrasion to ophthalmology other than for follow up ! this depend on site or size of abrasion December 15, 2017 at 8:03 AM Generally I refer to ophthalmology for the following – large deep and complex abrasion, especially over the pupil that affects vision and a child in who the exam is difficult and it is challenging to assess healing. Jennifer Cheney MD December 28, 2017 at 3:28 PM I think the easiest thing

2017 PEM Blog

11. An Observational Study to Determine Whether Routinely Sending Patients Home With a 24-Hour Supply of Topical Tetracaine From the Emergency Department for Simple Corneal Abrasion Pain Is Potentially Safe. (PubMed)

An Observational Study to Determine Whether Routinely Sending Patients Home With a 24-Hour Supply of Topical Tetracaine From the Emergency Department for Simple Corneal Abrasion Pain Is Potentially Safe. To determine if the number of emergency department (ED) rechecks, persistent fluorescein uptake, ophthalmology referrals, or complications would be affected by the prescription of topical tetracaine for pain relief from simple corneal abrasions (SCAs).This retrospective cohort study (...) was conducted in an ED where policy change allowed physicians to use topical tetracaine hydrochloride 1% eye drops for 24 hours for pain treatment for patients with corneal abrasions. Outcomes were compared between patients who did or did not received tetracaine (adjusting for the propensity for treatment).Of 1,576 initial ED presentations, 532 were SCAs, with 1,044 deemed nonsimple corneal abrasions (NSCAs). Tetracaine was dispensed at the initial visit for 303 SCA presentations (57%) and inappropriately

2017 Annals of Emergency Medicine

12. Efficacy of Topical Analgesics in Pain Control for Corneal Abrasions: A Systematic Review. (PubMed)

Efficacy of Topical Analgesics in Pain Control for Corneal Abrasions: A Systematic Review. Corneal abrasions are one of the most common ocular injuries seen in the emergency department. While most patients with corneal abrasions complain of excruciating pain, permanent sequelae may develop if not managed properly. The use of topical antibiotics and other standards of treatment have greatly reduced the incidence of complications. However, there is still a lack of consensus regarding the proper (...) management of pain in corneal abrasions. Proposed analgesics for the control of corneal abrasion pain include topical nonsteroidal anti-inflammatory drugs (NSAIDs), topical anesthetics, and topical cycloplegics. For this review, ten published randomized controlled trials were identified, focusing on the efficacy and safety of different topical analgesics used in treating corneal abrasions.  Six of the trials focused on topical NSAIDs, three on topical anesthetics, and one on topical cycloplegics

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2017 Cureus

13. Topical Cryopreserved Amniotic Membrane and Umbilical Cord Eye Drops Promote Re-Epithelialization in a Murine Corneal Abrasion Model. (PubMed)

Topical Cryopreserved Amniotic Membrane and Umbilical Cord Eye Drops Promote Re-Epithelialization in a Murine Corneal Abrasion Model. To evaluate morselized amniotic membrane and umbilical cord (AMUC) eye drops in promoting corneal re-epithelialization.Following a 2-mm diameter central epithelial wound in one eye of 48 normal C57BL/6 mouse corneas, 10 μL of saline with (n = 24) or without (n = 24) AMUC was applied three times a day for 6 days. The corneal epithelial defect was measured using (...) abrasion. Amniotic membrane and umbilical cord also achieved a more rapid complete epithelialization (3.15 ± 1.44 vs. 4.00 ± 1.63 days, P = 0.06) and induced a higher incidence of corneal regularity without affecting physical activity and body weight. Spearman correlation showed that epithelialization was significantly correlated with treatment groups (P < 0.001), time (P < 0.001), and corneal regularity (P = 0.04). Amniotic membrane and umbilical cord significantly decreased CD45+ cell infiltration

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2017 Investigative Ophthalmology & Visual Science

14. Bandage Contact Lenses for Corneal Abrasions

Bandage Contact Lenses for Corneal Abrasions Bandage Contact Lenses for Corneal Abrasions - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Bandage Contact Lenses for Corneal Abrasions The safety (...) by (Responsible Party): David Tanen, Los Angeles Biomedical Research Institute Study Details Study Description Go to Brief Summary: Two percent of all patients presenting to the Emergency Departments have complaints involving the eye. Corneal abrasions are a common diagnosis with patients with eye pain and often cause significant discomfort. Current treatment includes a thorough evaluation of the eye followed by patching, empiric antibiotics, cycloplegics and oral pain medicines. This study

2017 Clinical Trials

15. CCR2− and CCR2+ corneal macrophages exhibit distinct characteristics and balance inflammatory responses after epithelial abrasion (PubMed)

CCR2− and CCR2+ corneal macrophages exhibit distinct characteristics and balance inflammatory responses after epithelial abrasion Macrophages are distributed throughout the body and are crucial for the restoration of damaged tissues. However, their characteristics in the cornea and roles in the repair of corneal injures are unclear. Here we show that corneal macrophages can be classified as CCR2- macrophages, which already exist in the cornea at embryonic day 12.5 (E12.5) and are similar (...) to yolk sac-derived macrophages, microglia, in phenotype and gene expression, and CCR2+ macrophages, which do not appear in the cornea until E17.5. At a steady state, CCR2- corneal macrophages have local proliferation capacity and are rarely affected by monocytes; however, following corneal epithelial abrasion, most CCR2- corneal macrophages are replaced by monocytes. In contrast, CCR2+ macrophages are repopulated by monocytes under both a steady-state condition and following corneal wounding

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2017 Mucosal immunology

16. Management of traumatic corneal abrasion by a sample of practicing ophthalmologists in Saudi Arabia (PubMed)

Management of traumatic corneal abrasion by a sample of practicing ophthalmologists in Saudi Arabia Corneal epithelial defect (CED) is a common medical emergency condition involving loss of surface epithelial layer of the cornea. The aim of the study is to explore the practice patterns of ophthalmologists in management of traumatic CED in Saudi Arabia and to assess the variance in clinical practice from the established clinical practice guidelines.A Survey based study at King Abdulaziz (...) are reporting that traumatic CED mostly affects young people and fingernail trauma is the major cause. There is lack of clear institutional guidelines and consensus on the management of traumatic corneal abrasions.

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2017 Saudi Journal of Ophthalmology

17. Counterpoint: Topical Anesthetics for Corneal Abrasions

Counterpoint: Topical Anesthetics for Corneal Abrasions Counterpoint: Topical Anesthetics for Corneal Abrasions – Emergency Medicine Literature of Note Musings on Emergency Medicine, Clinical Informatics, & High-Value Care. articles recently discussing the potential utility of topical anesthetics for analgesia for corneal abrasions. The general point: there’s no consistent, modern evidence of harm, so why should we cling to older ways? Counterpoint from the corneal specialist community: cling (...) to old ways. In this long correspondence, the authors detail the physiologic basis for their opposition to topical anesthetics as it relates to stimulation of endothelial growth. They follow this up with a three question survey regarding the practice, distributed to “an international community of cornea trained specialists”. The clear winner in each of their three questions: “strongly disagree” with provision of topical anesthetics for acute corneal abrasions. Interestingly, they also conflate

2019 Emergency Medicine Literature of Note

18. Treatment of Corneal Abrasions With Topical Tetracaine

Treatment of Corneal Abrasions With Topical Tetracaine Treatment of Corneal Abrasions With Topical Tetracaine - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Treatment of Corneal Abrasions With Topical (...) Information provided by (Responsible Party): Charles Pereyra, New York Methodist Hospital Study Details Study Description Go to Brief Summary: Corneal abrasion (CA) is one of the most common eye injuries, accounting for 10% of eye-related emergency visits.1 A 1985 survey showed that around 3% of all visits to US general practitioners were for corneal abrasions. In addition, in 2008, approximately 27,450 work-related eye injuries and illnesses occurred that caused missed time from work.1Due to the large

2016 Clinical Trials

19. Perioperative Corneal Abrasion: Updated Guidelines for Prevention and Management. (PubMed)

Perioperative Corneal Abrasion: Updated Guidelines for Prevention and Management. Corneal abrasion is the most common ocular complication in surgery. Treatment requires pain control, antimicrobial prophylaxis, and close monitoring. Pain improves significantly after 24 hours and should be resolved by 48 hours. Persistent, worsening, or new symptoms warrant immediate specialist consultation. The authors review the pathophysiology of perioperative corneal abrasion, and propose updated evidence

2016 Plastic and reconstructive surgery

20. Corneal Abrasion

Corneal Abrasion Corneal Abrasion Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Corneal Abrasion Corneal Abrasion Aka: Corneal (...) times per day Polymixin B - Trimethoprim (Polytrim) 1 drop four times per day Extended spectrum agents (Anti-Pseudomonal agents, see indications above) (Ciloxan) 0.3% solution 2 drops every 4 hours (Ciloxan) 0.3% ointment apply 1/2 inch ribbon four times daily (Ocuflox) 0.3% solution 2 drops every 4 hours Avoid topical s (gentamycin, tobramycin) in Corneal Abrasion due to toxicity risk Other agents Chloramphenicol 1% ointment 2 drops q3 hours Reduces risk of Brief patch protocol Contraindicated

2018 FP Notebook

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