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Module 14--Current Emergency--Corneal Abrasion:

Terms in this set (4)

Essentials of Diagnosis:
--Pain, photophobia, and blurry vision.

--Uptake of fluorescein stain is key to diagnosis

--Always rule out globe perforation
Clinical Findings:
--Pt c/o pain, photophobia, and blurry vision.

--Pt's with severe pain and blepharospasm may require proparacaine, 0.5%, instilled in the eye to facilitate eye examination

--In severe cases, the eye is red and the corneal surface is irregular and loses its normal luster. Staining with fluorescein reveals a defect in the corneal epithelium.

--Rule out infection or globe perforation as needed.
Treatment:
--Irrigate the eye gently with sterile saline solution if needed to remove debris and loose foreign bodies.

--In severe cases, instill tropicamide to relax the ciliary muscle and relieve pain. Instill ophthalmic antibiotic ointment.

--Consider nonsteroidal anti-inflammatory ophthalmic drops for pain control.

--Provide systemic analgesia as needed.

--Never give the patient topical anesthetics, which may lead to irreversible corneal damage.

**Caution: Do not use ointment containing corticosteroids**
Disposition:
--Refer patients for daily outpatient follow-up care.

--Ophthalmologic consultation should be obtained for corneal abrasions that fail to resolve in 48-72 hours
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