Overview of Minor Eye Injuries

Physicians in emergency and primary care settings, or even optometrists, often encounter patients with minor eye wounds, such as corneal abrasions or conjunctival lacerations. These injuries can cause significant discomfort and potentially lead to serious complications if left untreated². Therefore, it is important for physicians to assess the injury's severity and provide appropriate treatment in a timely manner¹.

General indications for physicians treating minor eye wounds may include assessing the location and depth of the injury, identifying any foreign bodies or debris, and evaluating for signs of infection or inflammation¹. Treatment strategies may include the use of topical antibiotics, anti-inflammatory agents, and pain management medications². Additionally, patients should be closely monitored to ensure proper healing and prevent further complications.

Exploring Differential Diagnoses in Minor Eye Wounds

Patients presenting with symptoms of eye pain, light sensitivity, abnormal tearing, and foreign body sensation should always be evaluated with an initial eye examination to determine the possibility of an eye wound, and to rule out any other possible conditions related to ocular health². Other possible diagnoses that may initially present as minor eye wounds include²:

• Conjunctivitis
• Corneal ulcer
• Dry eye syndrome
• Uveitis
• Recurrent erosion syndrome
• Infective keratitis (bacterial, fungal, herpetic)

Therapies/Treatments in Minor Eye Wounds

Foreign Body Removal

To prevent permanent scarring and vision loss, corneal foreign bodies must be removed as soon as possible. Irrigation is usually effective, but if it fails, a topical anesthetic can be applied, and a gentle cotton swab can be used to remove the foreign body². If this method fails, a trained physician should remove the foreign body using an eye spud or needle². The removal process should be done using magnifying lenses or loupes to enhance visibility².

Oral & Topical Treatments

The primary objectives of treating eye wounds are to alleviate discomfort, prevent bacterial superinfection, and speed up the healing process. Treatment options can include the administration of oral analgesics, as well as topical medications such as antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), and cycloplegics². Controlled trials have only evaluated a limited number of treatments, so many of the recommendations are based on theoretical benefits and consensus among medical professionals².

Pain Relief

To alleviate discomfort, physicians may prescribe oral analgesics, topical NSAIDs, and in some cases, topical cycloplegics. Pain relief can often be achieved through the use of oral analgesics, such as acetaminophen and NSAIDs. However, prescribing topical anesthetics should be avoided, as they can harm the corneal epithelium with repeated use, delay the healing process, and obscure any worsening symptoms².

Antibiotics

Although there is limited evidence to support the use of topical antibiotics in uncomplicated corneal abrasions, they are often prescribed as a precautionary measure to prevent potential infection². In cases caused by contact lens use, foreign bodies, or traumatic injuries with infectious or vegetative matter, topical antibiotics are recommended due to the higher risk of secondary bacterial keratitis.

Topical antibiotics should be administered four times daily and continued until the patient is asymptomatic for 24 hours². Ointments are preferred over solutions due to their lubricating properties, which can lead to increased comfort and faster healing².

Hypochlorous Acid (HOCl)

Hypochlorous acid (HOCl) is a powerful, safe, effective, and natural disinfectant that is very useful as an antimicrobial cleanser and moisturizing solution in the treatment of minor eye wounds.

HOCl works by disrupting the cell walls and membranes of bacteria, viruses, and other pathogens, leading to their near-immediate destruction. A pure hypochlorous solution is highly effective against a wide range of bacteria, viruses, and fungi, and is renowned for its ability to target and destroy biofilm formations linked to chronic wound formation.

Despite its potent disinfectant properties, HOCl is as gentle as saline, making it completely safe for use on the eye and ocular skin. Striking this rare balance is what makes hypochlorous acid such a crucial component of the care protocol of any insult to human tissue, including the ocular and periocular areas.

HOCl also contains additional antiseptic and hydrating properties. Patients with minor eye wounds can use HOCl as an adjunctive therapy to prevent infection, reduce swelling, and aid in the healing process.

BIHOCL O.D. is our scientifically formulated HOCl product which is highly pure and ultra stable with a long shelf life. It features a gentle no-sting spray application, making it even easier for patients to use at home while ensuring patient compliance during the at-home treatment of their minor eye wound.

Final Thoughts

Minor eye wounds are a common injury that require effective and efficient care. As always, paying particular attention to patient symptoms and history will go a long way to an accurate diagnosis and treatment protocol. Symptoms such as foreign body sensation in the eye, eye pain, light sensitivity, and tearing all warrant an immediate eye examination. However, these symptoms may also be related to other diagnoses, such as dry eye conditions or conjunctivitis.

Prioritize foreign body removal, antibiotics, and pain relief for patient comfort and to prevent infection and vision loss, and strongly consider the use of hypochlorous acid (HOCl) as an adjunctive therapy for patients to use at home.