Related Experiment Videos
Management of corneal abrasion in children: a randomized clinical trial
Jeffrey G Michael1, Denise Hug, M Denise Dowd
1Division of Emergency Medicine, Children's Mercy Hospital, Kansas City, MO 64104, USA. pnjmichael@mchsi.com
Insights
Eye patching does not affect healing rates or discomfort for children with corneal abrasions. However, patching may increase difficulty with walking, with no observed complications in either treatment group.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Clinical Research
Background:
- Corneal abrasions are common eye injuries in children.
- Treatment options include eye patching or observation.
Purpose of the Study:
- To compare healing rates, comfort, and complications in pediatric patients with corneal abrasions treated with eye patches versus no eye patches.
Main Methods:
- A randomized clinical trial was conducted with 37 children (ages 3-17) diagnosed with isolated corneal abrasions.
- Patients were randomized to receive an eye patch or no patch.
- Healing was assessed by measuring abrasion size at 20-24 hours; comfort and pain medication use were also recorded.
Main Results:
- No significant difference in healing percentage (86% healed >=95%) or pain medication doses between the eye patch and no patch groups.
- No difference in overall interference with activities of daily living (ADL), except for a significantly greater difficulty walking score in the eye patch group.
- No complications were reported in either group.
Conclusions:
- Eye patching does not alter the healing rate of corneal abrasions in children.
- There is no significant difference in discomfort or interference with ADL, apart from increased difficulty walking with patching.
- Eye patching for pediatric corneal abrasions appears safe, with no observed complications.
Study Objective:
We compare percentage of healing, comfort, and complications in children with corneal abrasions treated with an eye patch versus no eye patch.
Methods:
We performed a randomized clinical trial of patients aged 3 to 17 years who were diagnosed with isolated corneal abrasion. Patients were randomly assigned to an eye patch or no patch group. Abrasion size was documented with digital photographs and/or an eye template diagram at presentation and at 20- to 24-hour follow-up examination. A reviewer masked to treatment group determined percent healing by measuring presentation and follow-up abrasion sizes on the photographs/template. At follow-up, interference with activities of daily living (ADL) was measured with a visual analog scale and the number of pain medication doses taken since presentation was recorded.
Results:
A total of 37 patients were enrolled: 17 with an eye patch and 18 with no eye patch. The mean patient age was 10 years, and two thirds of the patients were male. The majority (86%) of patients had 95% or more healing at follow-up, and there was no significant difference in percent healing between the 2 groups, even when adjusted for age and initial abrasion size (95% confidence interval [CI] for the difference in means -11 to 8 and -13 to 5, respectively). There was no difference between groups for number of pain medication doses required. Among measurements of interference with ADL, only the difficulty walking score was found to be significantly different between groups (patch mean 1.7 cm [SD 2.1 cm] versus no patch mean 0.3 cm [SD 0.7 cm]; 95% CI for the difference in means 0.3 to 2.5).
Conclusion:
This study suggests that eye patching in children with corneal abrasions makes no difference in the rate of healing. There was no difference in discomfort and interference with ADL, other than greater difficulty walking in the patch group, and there were no complications in either group.