This protocol applies to corneal foreign body cases where the mechanism of injury does not involve contact lens wear, vegetable or organic plant matter, or fingernails, and where the expected response to first-line management was not achieved at follow-up.
The presentation is a corneal foreign body from a mechanism other than contact lens wear, organic or vegetable plant matter, or fingernails. This mechanistic distinction informs both initial antibiotic selection and the threshold for escalation when recovery stalls.
Initial management consisted of corneal foreign body removal and antibiotic prophylaxis. The expected outcome was improvement of symptoms at the 24- to 48-hour follow-up, with the corneal abrasion typically healing within 2 to 3 days. When that improvement is not seen at follow-up, this protocol is indicated.
Failure to improve after initial management triggers a specific escalation path involving ophthalmologist involvement. The full protocol details the precise criteria, indications, and approach — see the complete regimen below.
DOI: 10.1016/j.pop.2015.05.004