An 8-year-old child has a vertical linear corneal abrasion seen on fluorescein staining; Pupils are equal and reactive. Which plan of care is appropriate?

An 8-year-old child has a vertical linear corneal abrasion seen on fluorescein staining; Pupils are equal and reactive. Which plan of care is appropriate?

• A. Close both eyes, and apply eye patches
• B. Instill antibiotic drops, and apply patches over both eyes
• C. Instill antibiotic ointment, but do not apply an eye patch
• D. Instill ophthalmic steroid drops three times a day, but do not apply an eye patch

Answer: (C)

The key idea is that uncomplicated corneal abrasions in children are treated to prevent infection and promote healing, without unnecessary eye patching. A simple corneal scratch shown by fluorescein staining, with pupils equal and reactive, does not require eye patching. Using a topical antibiotic ointment provides both antimicrobial protection and lubrication, helping the damaged surface heal while keeping the eye exposed so healing isn’t slowed by a patch. Steroid drops are not appropriate here because they can delay healing and increase infection risk. Patching, especially both eyes, can delay healing and isn’t needed for a straightforward abrasion. So, instilling antibiotic ointment and not applying an eye patch offers infection protection while allowing normal healing, with instructions to monitor for worsening pain, vision changes, or signs of infection and to return if needed.

The key idea is that uncomplicated corneal abrasions in children are treated to prevent infection and promote healing, without unnecessary eye patching. A simple corneal scratch shown by fluorescein staining, with pupils equal and reactive, does not require eye patching. Using a topical antibiotic ointment provides both antimicrobial protection and lubrication, helping the damaged surface heal while keeping the eye exposed so healing isn’t slowed by a patch. Steroid drops are not appropriate here because they can delay healing and increase infection risk. Patching, especially both eyes, can delay healing and isn’t needed for a straightforward abrasion. So, instilling antibiotic ointment and not applying an eye patch offers infection protection while allowing normal healing, with instructions to monitor for worsening pain, vision changes, or signs of infection and to return if needed.