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When the front of the eye is scratched, the standard treatment has been to put a few drops in the eye and to patch the eye for 24 hours. The undisturbed eye heals quickly from a corneal abrasion. The August 2001 issue of The Annals of Emergency Medicine contains a study where investigators did the standard treatment for half of the patients, and antibiotic eye drops alone (4 times a day) for the other half. All patients were adults. There was no difference in healing between the 2 groups, patch or no patch. Keeping the eye clean is an important part of the healing. I suspect, though, that children would have a tougher time not getting dirty fingers in their unpatched eyes than would adults. Also, giving eye drops 4 times a day can be tough for some families. I'd love to see the same study carried out with children. In the meantime, I plan to continue to examine these kids in person (with a Wood's light) to be sure that it is only a corneal abrasion. I will put in drops and place a patch at that time. If the parents have trouble keeping the patch on, they can use the eye drops instead for the rest of the treatment. It's wonderful how effective the eyes are at healing themselves when they don't get infected.
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