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Kristine K. Rittichier, MD; Mark G. Roback, MD; Kathlene E. Bassett, MD

Arch Pediatr Adolesc Med. 2000;154:370-374.

Background  Corneal abrasions are common eye injuries in children. Most are treated with antibiotic drops or ointment, patching of the affected eye, and follow-up within 24 hours to confirm resolution by fluorescein examination.

Objective  To determine if signs and symptoms at follow-up were associated with the presence of a persistent corneal abrasion or abnormal visual acuity.

Design  Retrospective case series.

Setting  A children's hospital.

Patients  Children who were aged 4 years or older with the diagnosis of corneal abrasion between May 1992 and December 1996 and who had a follow-up examination.

Results  Seventy-seven patients (57% male) were enrolled (median age, 7 years). The respective sensitivities, specificities, positive predictive values, and negative predictive values of selective signs and symptoms for persistent abrasions were as follows: for pain, 53%, 93%, 80%, and 80%; for photophobia, 57%, 100%, 100%, and 80%; for redness, 100%, 46%, 44%, and 100%; for pain and redness, 40%, 96%, 80%, and 80%; and for at least 1 sign or symptom, 95%, 48%, 47%, and 95%. Twenty-six patients had persistent corneal abrasions at follow-up. Six of these 26 patients were symptom free at follow-up, and 15 patients had only redness as a persistent sign. Five patients had abnormal visual acuity, one of whom was asymptomatic. All 3 patients with complications were symptomatic.

Conclusions  Signs and symptoms are inconsistently associated with persistent corneal abrasions. Asymptomatic patients may have persistent corneal abrasions, suggesting the need for selective follow-ups.

From the Primary Children's Medical Center, University of Utah, Salt Lake City (Drs Rittichier and Bassett), and the University of Colorado Health Sciences Center, The Children's Hospital, Denver (Dr Roback).

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