Management of corneal abrasions in an extended-wear patient population

Contact-lens-related corneal abrasions are a management problem for optometrists because of the risk of ulcerative keratitis, particularly from Pseudomonas. Risks and causes of abrasions should be identified for extended-wear patients, and appropriate steps should be taken to minimize the opportunity for injury. When an extended-wear patient presents with an abrasion, the clinician should take a careful history, conduct a thorough examination, and provide the necessary treatment: discontinuation of lens wear, irrigation of the cornea, use of cycloplegia and dilation of the pupil, utilization of the aminoglycoside tobramycin to treat the abrasion, no patching, and appropriate use of cold compresses and oral nonsteroidal anti-inflammatory drugs. Follow-up evaluations should be provided at 24 and 48 hours and at 3 to 5 days after the injury.