A corneal abrasion is a scratch on the eye’s clear outer layer, the cornea. This transparent tissue covers the iris and pupil, playing a significant role in focusing light onto the lens. Common causes of these injuries include accidental contact with foreign objects like dust, sand, or metal shavings, fingernail scratches, or even improper use of contact lenses. While often minor, corneal abrasions are a frequent eye injury that requires prompt attention to ensure proper healing and prevent further complications.
Why Antibiotics Are Essential
Antibiotics are prescribed for corneal abrasions primarily to prevent bacterial infection, rather than to treat the abrasion itself. A scratched cornea loses its protective barrier, making it susceptible to bacterial entry. This can lead to bacterial keratitis or a corneal ulcer. Such infections can cause significant vision loss or permanent scarring if left untreated. Therefore, topical antibiotics prevent these serious complications while the eye heals naturally.
Commonly Prescribed Antibiotics
For typical corneal abrasions, broad-spectrum antibiotics are often the initial choice due to their effectiveness against a wide range of common bacteria. Erythromycin ophthalmic ointment and polymyxin B/trimethoprim (Polytrim) drops are frequently recommended as first-line treatments, applied four times daily for several days. Sulfacetamide or bacitracin are other options sometimes considered for their broad coverage and good safety profiles.
Patients who wear contact lenses face a higher risk of infection from specific, more aggressive bacteria, particularly Pseudomonas aeruginosa. In these cases, stronger antibiotics are necessary to combat this bacterium. Fluoroquinolones such as ciprofloxacin, levofloxacin, moxifloxacin, or gatifloxacin are commonly prescribed because of their excellent coverage against Pseudomonas. These are often administered as drops multiple times a day, sometimes hourly for the first 48 hours, then tapered.
The specific antibiotic chosen depends on several factors, including the suspected source of the injury, the severity of the abrasion, and any patient-specific considerations like allergies or medical history. For instance, abrasions caused by vegetable matter may carry a higher risk for fungal infections, which would influence treatment decisions beyond standard bacterial coverage.
Application and Important Considerations
Antibiotics for corneal abrasions are prescribed as either eye drops or ointments. Eye drops are generally more comfortable, while ointments can provide longer contact time with the corneal surface but may temporarily blur vision. Always wash your hands before handling the medication and avoid touching the eye with the dispenser tip to prevent contamination.
The dosage frequency and duration of treatment will be specifically outlined by your healthcare provider, often ranging from three to seven days, or until the abrasion has fully healed. It is important to complete the entire course of antibiotics, even if symptoms improve quickly, to ensure the prevention of infection. Common, mild side effects can include temporary stinging or blurred vision, especially with ointments. If more severe reactions occur, such as increased pain, significant redness, or swelling, contact your doctor immediately.
After applying eye ointment, vision may be temporarily blurred, so caution should be exercised with activities like driving. For contact lens wearers, it is strongly advised to discontinue wearing lenses until the abrasion has completely healed and an eye care professional has given clearance.
Beyond Antibiotics: Supportive Care and When to Seek Help
Beyond antibiotic therapy, managing pain is important when caring for a corneal abrasion. Over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate discomfort. In some cases, a doctor might prescribe cycloplegic drops, which help relax the eye muscles and reduce pain associated with light sensitivity and muscle spasms. These drops can provide relief, especially for larger abrasions.
Follow-up appointments with an eye care professional are important to monitor healing and check for any complications. Minor abrasions heal within 24 to 72 hours, but larger ones may take longer. A follow-up ensures the cornea is healing properly and that an infection or corneal ulcer has not developed.
It is important to be aware of warning signs that may indicate a worsening condition or complication requiring immediate medical attention. These include increasing eye pain, worsening redness, significant changes in vision, the presence of pus or discharge from the eye, or increased sensitivity to light. If any of these symptoms appear, prompt consultation with an eye care professional is advised.