Topical analgesia for superficial corneal injuries.

Abstract

Flurbiprofen eye drops provide more effective pain relief than traditional treatments for superficial corneal injuries.

Is Homatropine 5% effective in reducing pain associated with corneal abrasion when compared with placebo? A randomized controlled trial

“…The only previously published literature found that a clinically significant reduction in pain at 12 h was reported by 45% of patients using placebo 8 but use of 5% homatropine has not been studied. For the purposes of the present study we arbitrarily determined that routine use of cycloplegics would appear warranted if at least 90% of patients using homatropine reported a clinically significant reduction in pain by 12 h and that this was clearly superior to placebo.…”

“…Corneal abrasion following trauma is a common and painful condition for which people seek treatment at hospital EDs 1–5 . Although corneal abrasion is common, management practices differ 6–10 . For pain originating from the damaged corneal epithelium there is evidence to suggest that topical non‐steroidal anti‐inflammatory drugs might lead to a modest reduction in early pain, 8,11 whereas patching the eye appears to confer no additional benefit 12–14 …”

Lack of consensus on corneal abrasion management: results of a national survey

“…While their use may seem physiologically intuitive, it has not been well studied. We found only 1 randomized controlled trial 18 looking at the use of cycloplegics for traumatic corneal abrasions. This study of lubrication, cycloplegics and topical flurbiprofen concluded that topical homatropine did not improve visual analog pain scores during the first 24 hours, but that topical NSAID therapy did.…”

“…Six of 7 randomized controlled trials [3][4][5][6][7][8]18 reported significant reductions in pain scores with NSAID use. The 7th found no significant difference in pain relative to placebo, but did document lower oral opioid requirements in the NSAID group.…”

“…17 The only randomized controlled trial examining the use of cycloplegics suggested they do not improve pain scores or reduce oral analgesic requirements. 18 Yet, despite a lack of evidence, topical antibiotics and cycloplegics remain recommended treatments in emergency medicine textbooks. 19,20 British investigators have documented substantial variability in corneal abrasion management among ophthalmology clinics.…”