{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T21:17:38Z","timestamp":1773436658748,"version":"3.50.1"},"reference-count":73,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T00:00:00Z","timestamp":1614902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Corneal abrasions are common ophthalmic presentations to emergency departments. Among emergency physicians and ophthalmologists, there are highly variable practice patterns with regard to management of resultant pain and discomfort. The goal of this study was to review and analyze the efficacy and safety of topical pain therapies for corneal abrasions, including topical anesthetics, nonsteroidal anti\u2010inflammatory drugs (NSAIDs), cycloplegics, steroids, pressure patching, and the use of a bandage contact lens (BCL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The review followed the Preferred Reporting Items for Systematic Review and Meta\u2010analysis (PRISMA) guidelines. The protocol was established a priori and published on PROSPERO (CRD42020201288). MEDLINE, EMBASE, CENTRAL, and Web of Science were searched until December 31, 2020. Primary studies comparing topical pain therapies to another therapy or control were included. Primary outcomes included percentage of corneal abrasions healed at 24, 48, and 72 hours, as well as pain control at 24 and 48 hours. Secondary outcomes included use of oral analgesia and incidence of complications. Risk of bias was assessed using validated tools. Quality of evidence was assessed using the GRADE methodology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 33 studies (31 randomized controlled trials [RCTs], two cohort studies) comprising 4,167 patients with corneal abrasions were analyzed. Only the data for topical NSAIDs were of adequate evidence from which to draw conclusions; topical NSAIDs demonstrated significantly reduced pain scores at 24 hours (standardized mean differences [SMD] \u20130.69, 95% CI\u00a0= \u20130.98 to \u20130.41) and 48 hours (SMD\u00a0= \u20130.56, 95% CI\u00a0= \u20131.02 to \u20130.10) as well as 53% (95% CI\u00a0= 34% to 67%) lower oral analgesia use compared to control. Based on available data, topical anesthetics, cycloplegics, patching, and the use of a BCL did not result in any significant difference in pain scores or use of oral analgesia, while no studies examined topical steroids. No interventions resulted in healing delays or significantly higher rates of complications compared to controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There was strong evidence to support that topical NSAIDs reduce pain associated with corneal abrasions in the first 48 hours and the need for oral analgesia. The existing evidence was insufficient to support or refute the use of topical anesthetics, cycloplegics, steroids, or BCL for pain control in corneal abrasions. Pressure patching was ineffective at pain reduction and may increase the risk of complications. Delays in healing or other complications were not significantly different between any intervention or control for simple, uncomplicated corneal abrasions; however, larger RCTs are required to identify any differences in rare complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14222","type":"journal-article","created":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T02:27:14Z","timestamp":1611887234000},"page":"890-908","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Topical pain control for corneal abrasions: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4287-2328","authenticated-orcid":false,"given":"Caberry W.","family":"Yu","sequence":"first","affiliation":[{"name":"Faculty of Medicine Queen\u2019s University Kingston Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abirami","family":"Kirubarajan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Yau","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Queen\u2019s University Kingston Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davin E.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Kingston Health Sciences Centre Queen\u2019s University Kingston Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107688307600408"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pop.2015.05.004"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.1998.220"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(68)93082-1"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.emc.2007.11.003"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2005.032557"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1481803500009398"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.81.12.1115c"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12346"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12009-000-0071-9"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(97)83472-9"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.1993.95"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000347125"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1481803500012537"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/112067210101100304"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(95)30926-8"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2019.07.001"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e3181e458af"},{"issue":"7","key":"e_1_2_9_20_1","first-page":"CD004764","article-title":"Patching for corneal abrasion","volume":"7","author":"Lim CH","year":"2016","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2015.06.069"},{"issue":"5","key":"e_1_2_9_22_1","first-page":"CD009781","article-title":"Topical non\u2010steroidal anti\u2010inflammatory drugs for analgesia in traumatic corneal abrasions","volume":"5","author":"Wakai A","year":"2017","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebm.8.6.176"},{"key":"e_1_2_9_24_1","unstructured":"HigginsJP GreenS eds.Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[Updated March 2011]. 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