Corneal abrasions are one of the most common ocular
injuries seen in the emergency department. While most patients with
corneal abrasions complain of excruciating
pain, permanent sequelae may develop if not managed properly. The use of topical
antibiotics and other standards of treatment have greatly reduced the incidence of complications. However, there is still a lack of consensus regarding the proper management of
pain in
corneal abrasions. Proposed
analgesics for the control of
corneal abrasion pain include topical nonsteroidal anti-inflammatory drugs (
NSAIDs),
topical anesthetics, and topical
cycloplegics. For this review, ten published randomized controlled trials were identified, focusing on the efficacy and safety of different topical
analgesics used in treating
corneal abrasions. Six of the trials focused on topical
NSAIDs, three on
topical anesthetics, and one on topical
cycloplegics. There were mixed results regarding the efficacy of topical
analgesics in reducing
pain in patients with
corneal abrasions. This review of the literature revealed that topical
NSAIDs produced reductions in
pain symptoms, whereas
topical anesthetics and
cycloplegics did not demonstrate significant improvements in either healing rates or
pain control. Thus, this evidence supports the use of topical
NSAIDs in the standard management of
corneal abrasions. Unfortunately, the power of these studies is largely limited by small sample sizes. Larger studies must be conducted before topical
analgesics can be recommended or discouraged for
pain management in
corneal abrasions. However, based on this review of the literature, the use of topical
NSAIDs does not appear to complicate wound healing, and thus remains a safe option in patients desiring medical treatment.