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Corneal Abrasion, Emergency Medicine

Denise S. Lawe Reviewed 06/2017
 


Basics

Description

  • Any tear or defect in the corneal epithelium

  • May be traumatic, spontaneous, due to foreign body, or contact lens related

Etiology

  • Traumatic:

    • Human fingernail

    • Branches

    • Hairbrushes/combs

    • Sand...

Diagnosis

Signs and Symptoms

  • Severe ocular pain

  • Gritty (scratchy) discomfort

  • Tearing

  • Blepharospasm

  • Foreign body sensation

  • Photophobia (particularly if secondary traumatic iritis present)

  • Conjunctival injecti...

Treatment

Initial Stabilization/Therapy

Instill topical anesthetic (proparacaine/tetracaine). 

Ed Treatment/Procedures

  • Removal of superficial foreign body:

    • A residual rust ring does not need emergent remo...

Follow-Up

Disposition

Admission Criteria

Associated injuries requiring admission 

Discharge Criteria

All simple corneal abrasions 

Issues for Referral

No studies on optimal follow-up. Practice recommendatio...

Pearls and Pitfalls

  • Always diligently evaluate for penetrating trauma to the globe.

  • Always diligently evaluate for evidence of infection.

  • Do not discharge the patient with any topical anesthetic. It is ...

Additional Reading

  • Calder  LA, Balasubramanian  S, Fergusson  D. Topical nonsteroidal anti-inflammatory drugs for corneal abrasions: Meta-analysis of randomized trials. Acad Emerg Med.  2005;12:4...

Codes

ICD9

918.1 Superficial injury of cornea 

ICD10

  • S05.00XA Inj conjunctiva and corneal abrasion w/o fb, unsp eye, init

  • S05.01XA Inj conjunctiva and corneal abrasion w/o fb, right eye, init

  • S05.02XA Inj ...

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