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Lack of consensus on corneal abrasion management: results of a national survey

Published online by Cambridge University Press:  21 May 2015

Lisa Calder ,
Sowmya Balasubramanian  and
Ian Stiell
Lisa Calder*
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, Ont
Sowmya Balasubramanian
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, Ont
Ian Stiell
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, Ont
*
Department of Emergency Medicine, The Ottawa Hospital, Civic Campus, 1053 Carling Ave., Ottawa ON K1Y 4E9; 613 798-5555 x17484, lcalder@sympatico.ca

Abstract:

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Objectives:

Our objective was to determine the practice patterns of Canadian emergency physicians with respect to the management of traumatic corneal abrasions.

Methods:

After developing our instrument and pilot testing it on a sample of emergency residents, we randomly surveyed 470 members of the Canadian Association of Emergency Physicians, using a modified Dillman technique. We distributed a pre-notification letter, an 18-item survey, and appropriate follow-up surveys to non-responders. Those members with an email address (n = 400) received a Web-based survey, and those without (n = 70) received a survey by post. The survey focused on the indications and utilization of analgesics (oral and topical), cycloplegics, eye patches and topical antibiotics.

Results:

Our response rate was 64% (301/470), and the median age of respondents was 38 years. Most (77.7%) were male, 71.8% were full-time emergency physicians, 76.5% were emergency medicine certified, and 64.4% practised in teaching hospitals. Pain management preferences (offered usually or always) included oral analgesics (82.1%), cycloplegics (65.1%) and topical nonsteroidal anti-inflammatory drugs (NSAIDs) (52.8%). Only 21.6% of respondents performed patching, and most (71.2%) prescribed topical antibiotics, particularly for contact lens wearers and patients with ocular foreign bodies. Two-thirds of the respondents provided tetanus toxoid if a foreign body was present, and 46.2% did so even if a foreign body was not present. Most respondents (88.0%) routinely arranged follow-up.

Conclusions:

This national survey of emergency physicians demonstrates a lack of consensus on the management of traumatic corneal abrasions. Further study is indicated to determine the optimal treatment, particularly regarding the use of topical NSAIDs.

Keywords

corneal abrasionsurveyemergency medicine
Type
Em Advances • Innovations en MU
Information
Canadian Journal of Emergency Medicine , Volume 6 , Issue 6 , November 2004 , pp. 402 - 407
Copyright
Copyright © Canadian Association of Emergency Physicians 2004

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