Conjunctival abrasion: Difference between revisions
(Expand with concise EM-focused content: differential, evaluation, management) |
|||
| (One intermediate revision by one other user not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Superficial disruption of the conjunctival epithelium from trauma, foreign body, or chemical exposure | |||
*Conjunctiva has less innervation than cornea | *Conjunctiva has less innervation than cornea → patients are far less symptomatic than with [[corneal abrasion]] | ||
*Heals rapidly (typically within 24-48 hours) | |||
==Clinical Features== | ==Clinical Features== | ||
*Foreign body sensation | *Foreign body sensation | ||
*Mild [[eye pain|pain]] | *Mild [[eye pain|pain]] or irritation | ||
*Tearing, mild redness | |||
*Photophobia (rare) | *Photophobia (rare) | ||
*[[Subconjunctival hemorrhage]] | *[[Subconjunctival hemorrhage]] may be present | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Corneal abrasion]] | |||
*[[Conjunctival laceration]] | |||
*[[Subconjunctival hemorrhage]] | |||
*[[Conjunctivitis]] | |||
*[[Open globe injury]] (must rule out with high-energy mechanism) | |||
==Evaluation== | ==Evaluation== | ||
*[[Slit-lamp]] exam with fluorescein | *Visual acuity | ||
* | *[[Slit-lamp]] exam with fluorescein staining — conjunctival uptake without corneal involvement | ||
*'''Seidel test''' to rule out globe perforation (especially if mechanism of concern) | |||
*Evert eyelids to look for retained [[ocular foreign body|foreign body]] | |||
==Management== | ==Management== | ||
*Remove | *Remove any conjunctival foreign bodies | ||
*[[Erythromycin]] ointment 0.5% QID | *[[Erythromycin]] ointment 0.5% QID × 2-3 days (prophylaxis) | ||
* | *Artificial tears PRN for comfort | ||
*Suturing is almost never required (conjunctiva heals rapidly) | |||
*No eye patching needed | |||
==Disposition== | |||
*Discharge with erythromycin ointment | |||
*Follow-up only if worsening symptoms; most heal within 24-48 hours | |||
==See Also== | ==See Also== | ||
*[[Corneal | *[[Corneal abrasion]] | ||
*[[Conjunctival laceration]] | |||
*[[Ocular foreign body]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Ophthalmology]] | [[Category:Ophthalmology]] | ||
Latest revision as of 01:25, 21 March 2026
Background
- Superficial disruption of the conjunctival epithelium from trauma, foreign body, or chemical exposure
- Conjunctiva has less innervation than cornea → patients are far less symptomatic than with corneal abrasion
- Heals rapidly (typically within 24-48 hours)
Clinical Features
- Foreign body sensation
- Mild pain or irritation
- Tearing, mild redness
- Photophobia (rare)
- Subconjunctival hemorrhage may be present
Differential Diagnosis
- Corneal abrasion
- Conjunctival laceration
- Subconjunctival hemorrhage
- Conjunctivitis
- Open globe injury (must rule out with high-energy mechanism)
Evaluation
- Visual acuity
- Slit-lamp exam with fluorescein staining — conjunctival uptake without corneal involvement
- Seidel test to rule out globe perforation (especially if mechanism of concern)
- Evert eyelids to look for retained foreign body
Management
- Remove any conjunctival foreign bodies
- Erythromycin ointment 0.5% QID × 2-3 days (prophylaxis)
- Artificial tears PRN for comfort
- Suturing is almost never required (conjunctiva heals rapidly)
- No eye patching needed
Disposition
- Discharge with erythromycin ointment
- Follow-up only if worsening symptoms; most heal within 24-48 hours