Recurrent symptoms following traumatic corneal abrasion: prevalence, severity, and the effect of a simple regimen of prophylaxis.
OBJECTIVE
(i) To describe the course of ocular symptoms and recurrent corneal erosion (RCE) following traumatic corneal abrasion (TCA). (ii) To assess the efficacy of a regimen of nightly eye ointment in preventing symptoms and RCE.


METHODS
Patients presenting with TCA were treated with g. cyclopentolate 1% stat. and oc. chloramphenicol q.d.s. for 5 days. Eye pads were not used. For injuries caused by a fingernail, patients were randomised to receive either this 'standard regimen' alone, or to follow with a lubricating ointment (Lacrilube) nocte for 2 months. Follow-up was by telephone, using a symptom-based questionnaire. Recurrent symptoms were graded as: (i) none or minimal, (ii) mild, (iii) moderate (difficulty with some activities, or sought further opinion) and (iv) disabling (confirmed macroform RCE). After 2 years, case-notes were reviewed. The study is continuing, with further telephone follow-up taking place.


RESULTS
Three-month follow-up was completed for 42 'fingernail' injuries and 32 'non-fingernail' TCAs. When treated with our standard regimen, 'mild' symptoms were reported in 10% of 'fingernail' and 10% of 'non-fingernail' injuries. Symptoms were 'moderate' in 0 and 12% respectively. Chisquared test confirmed a significantly higher prevalence of recurrent symptoms in the 'additional nightly ointment' group of 'fingernail' injuries (p = 0.016). Two macroform RCEs were confirmed by 2 years: one from each treatment group of 'fingernail' injury.


CONCLUSIONS
When TCA is managed as above, there is a high prevalence of recurrent symptoms in the following 3 months. Additional nightly ointment appears to worsen prognosis. Macroform RCE is not common in the 2 years following TCA.
Eke
T
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Department of Ophthalmology, Leicester Royal Infirmary, UK.
Morrison
D A
DA
Austin
D J
DJ
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002701:Chloramphenicol / Q000627:therapeutic use; D065306:Corneal Injuries; D003320:Corneal Ulcer / Q000209:etiology* / Q000517:prevention & control; D003519:Cyclopentolate / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D008153:Lubrication; D009184:Mydriatics / Q000627:therapeutic use; D009262:Nails; D009824:Ointments; D011446:Prospective Studies; D012008:Recurrence
D000900:Anti-Bacterial Agents; D009184:Mydriatics; D009824:Ointments; D002701:Chloramphenicol; D003519:Cyclopentolate