Corneal Laceration Treatment & Management

  • Author: Andrew A Aronson, MD, FACEP; Chief Editor: Barry E Brenner, MD, PhD, FACEP   more...
 
Updated: Apr 12, 2011
 

Prehospital Care

  • Cover the patient's eye with an eye shield or polystyrene/paper cup and avoid any pressure to the globe.
  • Instruct the patient to move the eyes as little as possible.
  • Administer antiemetic and analgesic medication in order to reduce pressure on the globe.
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Emergency Department Care

Perform an examination to ascertain the extent of the corneal, anterior chamber, ocular, and associated (eg, facial, cranial) injuries.

  • Ophthalmologic consultation is indicated to convey the practitioner's findings and to decide on the appropriate evaluation, treatment, and timing of ophthalmologic evaluation.
  • Place a protective eye shield (prefabricated or custom made) on the injured eye. This can be a commercial plastic eye shield or simply a polystyrene/paper cup taped over the eye.
  • Administer antiemetics and systemic analgesic medication.
  • Tetanus immunization or booster is indicated.
  • In consultation with the ophthalmologist, discuss the administration of antibiotics including route (topical or intravenously) and frequency.
  • In general, topical analgesia and antibiotics should be avoided if a corneal laceration is suspected. Use systemic analgesia and antibiotics. Topical anesthetics may be used, if needed, to facilitate visual acuity testing and the slit lamp examination.
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Consultations

Ophthalmologic consultation is necessary. The two practitioners must decide and document when and where the consultation will occur.

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Contributor Information and Disclosures
Author

Andrew A Aronson, MD, FACEP  Vice President, Physician Practices, Bravo Health Advanced Care Center; Consulting Staff, Department of Emergency Medicine, Taylor Hospital, Ridley Park, Pennsylvania

Andrew A Aronson, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, Massachusetts Medical Society, and Society of Hospital Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Nelson M Yang, MD  Staff Physician, Department of Emergency Medicine, Allegheny General Hospital

Disclosure: Nothing to disclose.

Specialty Editor Board

William K Chiang, MD  Associate Professor, Department of Emergency Medicine, New York University School of Medicine; Chief of Service, Department of Emergency Medicine, Bellevue Hospital Center

William K Chiang, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Medical Toxicology, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Douglas Lavenburg, MD  Clinical Professor, Department of Emergency Medicine, Christiana Care Health Systems

Douglas Lavenburg, MD is a member of the following medical societies: American Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP  Professor of Emergency Medicine, Professor of Internal Medicine, Program Director, Emergency Medicine, University Hospitals, Case Medical Center

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

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