ITEMS IN AFP WITH MESH TERM:
Management of Corneal Abrasions - Article
ABSTRACT: Corneal abrasions result from cutting, scratching, or abrading the thin, protective, clear coat of the exposed anterior portion of the ocular epithelium. These injuries cause pain, tearing, photophobia, foreign body sensation, and a gritty feeling. Symptoms can be worsened by exposure to light, blinking, and rubbing the injured surface against the inside of the eyelid. Visualizing the cornea under cobalt-blue filtered light after the application of fluorescein can confirm the diagnosis. Most corneal abrasions heal in 24 to 72 hours and rarely progress to corneal erosion or infection. Although eye patching traditionally has been recommended in the treatment of corneal abrasions, multiple well-designed studies show that patching does not help and may hinder healing. Topical mydriatics also are not beneficial. Initial treatment should be symptomatic, consisting of foreign body removal and analgesia with topical nonsteroidal anti-inflammatory drugs or oral analgesics; topical antibiotics also may be used. Corneal abrasions can be avoided through the use of protective eyewear.
Patching for Corneal Abrasions? - Cochrane for Clinicians
LASIK: A Primer for Family Physicians - Article
ABSTRACT: Surgical correction of vision is becoming increasingly popular. Laser-assisted in situ keratomileusis (LASIK) is the most popular method of corneal refractive surgery. LASIK is usually limited to adults who have stable refraction. Contraindications include the use of certain medications, conditions that impair healing, abnormal corneal anatomy, and inadequate tearing. Patients who cannot tolerate persistent eye dryness or who engage in activities with a risk of eye trauma should avoid LASIK. Possible complications include diffuse lamellar keratitis, epithelial ingrowth, and fap complications. Almost all patients achieve uncorrected visual acuity of at least 20/40, but higher degrees of preoperative myopia may require a second operation. Long-term data on safety and stability are just becoming available. LASIK appears to be safe and effective, with only a small tendency for increased myopia in the first few years after surgery.
ABSTRACT: Corneal abrasions are commonly encountered in primary care. Patients typically present with a history of trauma and symptoms of foreign body sensation, tearing, and sensitivity to light. History and physical examination should exclude serious causes of eye pain, including penetrating injury, infective keratitis, and corneal ulcers. After fluorescein staining of the cornea, an abrasion will appear yellow under normal light and green in cobalt blue light. Physicians should carefully examine for foreign bodies and remove them, if present. The goals of treatment include pain control, prevention of infection, and healing. Pain relief may be achieved with topical nonsteroidal anti-inflammatory drugs or oral analgesics. Evidence does not support the use of topical cycloplegics for uncomplicated corneal abrasions. Patching is not recommended because it does not improve pain and has the potential to delay healing. Although evidence is lacking, topical antibiotics are commonly prescribed to prevent bacterial superinfection. Contact lens–related abrasions should be treated with antipseudomonal topical antibiotics. Follow-up may not be necessary for patients with small (4 mm or less), uncomplicated abrasions; normal vision; and resolving symptoms. All other patients should be reevaluated in 24 hours. Referral is indicated for any patient with symptoms that do not improve or that worsen, a corneal infiltrate or ulcer, significant vision loss, or a penetrating eye injury.