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Eye patches are not indicated for simple corneal abrasions

Three Part Question

In [patients with superficial corneal abrasions] is [an eye patch better than no eye patch] at reducing [pain and time to healing]

Clinical Scenario

A young woman attends the Emergency Department with pain in her right eye. Her infant son has inadvertently put his hand in her eye. Examination reveals a corneal abrasion. You wonder whether an eye patch should be applied to protect the cornea.

Search Strategy

Medline 1966-12/98 using the OVID interface.
{[exp eye injuries OR exp eye foreign bodies OR corneal abrasion$.mp] AND [exp bandages OR eye patch$.mp OR patch$.mp]} AND [maximally sensitive RCT filter].

Search Outcome

41 papers found of which 28 irrelevant and 4 of insufficient quality for inclusion

Relevant Paper(s)

Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses
Hulbert MF
30 patients with corneal abrasion after foreign body removal Chloramphenicol and eye patch vs chloramphenicol alonePRCTDiscomfortGreater at 24h
Time to healingNo difference
Kirkpatrick JN et al
** patients with simple traumatic corneal abrasions Antibiotic, mydriatic and eye patch vs antibiotic and mydriatic alonePRCTTime to healingSignificantly <0.05) better in antibiotic alone group
Patterson J et al
33 patients with eye pain and corneal abrasion Eye patch vs no eye patchPRCTPain scoreNo differenceSmall study - low power
Analgesic useNo difference
Kaiser PK
201 patients with non-infected non contact lens related traumatic (120) or post foreign body removal (81) corneal abrasions. Antibiotic, mydriatic and eye patch vs antibiotic and mydriatic alonePRCTPainSignificantly less in antibiotic/mydriatic alone group
Time to healingSignificantly less in antibiotic/mydriatic alone group
Blurred visionSignificantly less in antibiotic/mydriatic alone group for traumatic abrasions, no difference for abrasions post foreign body removal.
Campanile TM et al
64 patients with traumatic corneal abrasion Patched vs unpatchedPRCTRate of healing at day 1Significantly faster in unpatchedOnly recorded at 1 day
Hart A et al
99 patients with corneal abrasion Eye pad vs no eye padControlled trialDuration of painNo significant difference
Arbour JD et al
48 eyes (46 patients) with corneal erosion Patching vs no patchingPRCTLinear and surface speed of reepithelialisationNo significant difference
PainNo significant difference
InsomniaNo significant difference


There are 6 PRCTs of varying quality and power in this area. All show no benefit from patching and the largest shows positive benefit from no patch.

Clinical Bottom Line

Patients with corneal abrasion should not have an eye patch.


  1. Hulbert MF. Efficacy of eyepad in corneal healing after corneal foreign body removal. Lancet 1991;337:643.
  2. Kirkpatrick JN, Hoh HB, Cook SD. No eye pad for corneal abrasion. Eye 1993;7:468-71.
  3. Patterson J, Fetzer D, Krall J et al. Eye patch treatment for the pain of corneal abrasion. South Med J 1996;89:227-229.
  4. Kaiser PK. A comparison of pressure patching versus no patching for corneal abrasions due to trauma or foreign body removal. Opthalmol 1995;102:1936-1942.
  5. Campanile TM, St Clair DA, Benaim M. The evaluation of eye patching in the treatment of traumatic corneal epithelial defects. J Emerg Med 1997;15:769-774.
  6. Hart A, White S, Conboy P et al. The management of corneal abrasions in accident and emergency. Injury 1997;28:527-529.
  7. Arbour JD, Brunette I, Boisjoly HM et al. Should we patch corneal erosions? Arch Opthalmol 1997;115:313-317.