Patching the eye following a simple corneal abrasion caused by trauma or foreign body

Turner A, Rabiu M

Published Online:

January 21, 2009

The cornea is the transparent outer layer of the eye. Scratches or superficial damage to the cornea are common problems and are very painful. A common treatment option has been to place an occluding patch over the eye. This review of 11 randomised controlled studies found that the use of patches slows the healing on the first day after the injury and made no difference to pain levels. Further research should focus on large (greater than 10 mm²) abrasions.

Abstract (click to read)

Background:

Recent audits show that corneal abrasion is a common presenting eye complaint. Eye patches are often recommended for treating corneal abrasions despite the lack of evidence for their use. This systematic review was conducted to determine the effects of the eye patch when used to treat corneal abrasions.

Objectives:

The objective of this review was to test the hypothesis that patching an eye following a corneal abrasion improves healing or provides pain relief.

Search strategy:

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) in The Cochrane Library (2007, Issue 4), MEDLINE (1966 to December 2007), EMBASE (1980 to December 2007), LILACS (3 December 2007), NRR (2007, Issue 4) and SIGLE (December 2004). There were no language or date restrictions in the searches. We also searched the reference lists of included studies, unpublished 'grey' literature and conference proceedings and contacted pharmaceutical companies for details of unpublished trials.

Selection criteria:

We included randomised and quasi-randomised controlled trials that compared patching the eye with no patching to treat simple corneal abrasions.

Data collection and analysis:

Two authors independently assessed trial quality and extracted data. We contacted investigators for further information regarding quality of trials. The primary outcome was healing of the corneal epithelium and secondary outcomes were related to pain.

Main results:

Eleven trials, which randomised a total of 1014 participants, were included in the review. Meta-analysis of seven studies with dichotomous healing outcomes favoured no patching on the first day of healing (risk ratio (RR) 0.89, 95% Confidence Interval (CI) 0.79 to 0.99). For days two and three there was no significant difference between the two groups. Of the nine trials that measured pain scores two favoured no patching and none favoured patching. Complication rates were low and no differences were noted in these between the two groups. No-patch groups generally received more adjuvant treatment with antibiotics and/or cycloplegics than the patch group which is an important confounding factor.

Authors' conclusions:

Treating simple corneal abrasions with a patch does not improve healing rates on the first day post-injury and does not reduce pain. In addition, use of patches results in a loss of binocular vision. Therefore it is recommended that patches should not be used for simple corneal abrasions. Further research should focus on large (greater than 10 mm2) abrasions.

This record should be cited as:

Turner A, Rabiu M. Patching for corneal abrasion. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD004764. DOI: 10.1002/14651858.CD004764.pub2

Assessed as up to date:

December 3, 2007

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Primary Review Group:

Eyes and Vision Group

Health topics:

Eyes & vision > Corneal disease > Corneal erosion or abrasion

Eyes & vision > Eye injuries

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Independent high-quality evidence for health care decision making

Patching the eye following a simple corneal abrasion caused by trauma or foreign body

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