THE MANAGEMENT OF CORNEAL ABRASIONS IN ACCIDENT AND EMERGENCY

Recent debate over the use of eyepads and mydriatics for corneal abras ions in ophthalmology departments (Mindin et al., 1996, JAMA 1996; 27: 837) has prompted this review of the management of small corneal abra sions (<60% of cornea) in a large teaching hospital accident and emerg ency (A&E) department. Ninety-nine patients were studied who presented to the Leicester Royal Infirmary A&E Department with a corneal abrasi on; 49 were given an eye pad and 50 were not given an eye pad. All pat ients received chloramphenicol (1%) ointment. There was no significanc e difference between the two groups in ter ms of the duration of pain (p > 0.2). Four patients developed corneal infections (two wore an eye pad, two had no eye pad). There was only one patient who suffered a tr ansient but significant reduction in visual acuity (6/9-6/18), followi ng the use of an eye pad and subsequent diagnosis in eye casualty of a dendritic ulcer. It is concluded that accident and emergency treatmen t of small corneal abrasions is safe and effective if an eye pad is no t given. Previous criticisms of A&E management of eye problems (Nayeen and Stansfield, Archs Emerg Med, 1992; 9: 257) are unfounded in this department. (C) 1997 Elsevier Science Ltd. All rights reserved.