I think the standard of care now for corneal abrasion treatment does not include eye patching. I also believe that the old teaching of no pain medication until the surgeon has examined the patient has also been replaced with appropriate pain management occurring early in the care plan for patients presenting with acute abdominal pain.
In the case of corneal abrasions, overwhelming data showing no benefit won out. I believe that the change in the management of acute abdominal pain was a combination of data along with advances in diagnostic imaging.
References
1. Wilkins. Emergency Medicine. 1989 Williams and Wilkins, Baltimore, Md.
2. Br Med J. 1960 Sep 3;2(5200):713.
3. Ophthalmology. 1995 Dec;102(12):1936-42.
4. Lancet. 1991 Mar 16;337(8742):643.
6. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD004764.
7. Ophthalmic Res. 2013;50(1):13-8.
8. Cope’s Early Diagnosis of the Acute Abdomen, 15th Edition, Oxford University Press, 1979.
9. Cope’s Early Diagnosis of the Acute Abdomen, 16th Edition, Oxford University Press, 1983.
10. BMJ. 1992 Sep 5;305(6853):554-6.
11. Emerg Med J. 2008 Sep;25(9):586-9.
12. Acad Emerg Med. 1996 Dec;3(12):1086-92.
Dr. Paauw is professor of medicine in the division of general internal medicine at the University of Washington, Seattle, and he serves as third-year medical student clerkship director at the University of Washington. Contact Dr. Paauw at dpaauw@uw.edu.