Clinical Question: Do topical nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain associated with corneal abrasion?

Setting: Various (meta-analysis)

Study Design: Systematic review

Synopsis: This review summarizes five masked randomized studies comparing the value of ophthalmic NSAIDs in the treatment of pain associated with corneal abrasions.

The reviewers searched standard English-language databases available through OVID, but they did not search European databases. The studies were loosely evaluated for quality, but the researchers did not report this evaluation for every study.

All five studies showed that NSAIDs decreased pain to a small degree that may not be clinically relevant in all patients (on average, a less than 1.5-cm difference on a 10-cm pain scale). However, one study found that treated patients returned to work significantly earlier. Interestingly, one study allowed eye patching if pain was unbearable, even though studies of unilateral patching have shown slightly worsened pain when the affected eye is patched.

Bottom Line: Use of topical NSAIDs offers minimal pain relief in patients with a corneal abrasion. (Level of Evidence: 1a)