facilitate corneal and conjunctival healing Clinical Considerations Clinical Recognition Corneal or conjunctival abrasions may occur even from mild surface trauma, including accidental self-inflicted injuries Corneal abrasion can be painful and accompanied by dramatic photophobia and resistance to opening of the eyes Patients may complain of a foreign-body sensation even though no foreign body is present In the absence of clinical findings associated with other more severe injuries and in association with a mechanism of injury that may lead to a scratching of the cornea, abrasion should be suspected in a painful, red eye In newborns who have unexplained fussiness, corneal abrasion is common, as young infants not yet have sufficient motor control to avoid scratching the eye surface Triage Considerations Patients with severe eye pain and redness should be promptly triaged and assessed Pain control is a primary concern Analgesics should be initiated in all cases Management Literature suggests that patching corneal abrasions does not accelerate healing or decrease pain Many physicians suggest applying a lubricating antibiotic ointment (e.g., bacitracin, erythromycin, Polysporin) three times daily for to days to the ocular surface without a patch Topical nonsteroidal anti-inflammatory agents are used for pain control in adults, but are rarely used for children There is a theoretical risk of corneal melting with these agents For patients who are relatively asymptomatic with corneal or conjunctival abrasions that are small and not involve the pupillary axis (i.e., not involving the central cornea over the pupil), management with antibiotic or artificial tears alone may be sufficient The use of mydriatic drops such as cyclopentolate 1% can be instilled to relieve ciliary spasm, though this is uncommon Ointments containing steroids or neomycin should not be used If the patient is asymptomatic within 48 hours, no follow-up is required Larger corneal abrasions and those involving the pupillary axis should be seen on the day following the injury by an ophthalmologist For any size corneal abrasion, if pain or foreign-body sensation continues for more than days, or if there is increasing pain and redness, the patient should be instructed to seek ophthalmologic care