Management of corneal abrasion in children: a randomized clinical trial.
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).


CONCLUSIONS
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.
Michael
Jeffrey G
JG
Division of Emergency Medicine, Children's Mercy Hospital, Kansas City, MO 64104, USA. pnjmichael@mchsi.com
Hug
Denise
D
Dowd
M Denise
MD
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D065306:Corneal Injuries; D005129:Eye Foreign Bodies / Q000628:therapy; D005131:Eye Injuries / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009779:Occlusive Dressings; D010146:Pain / Q000503:physiopathology; D016896:Treatment Outcome; D014945:Wound Healing